Implementation of an electronic system for medication reconciliation

Kramer, Joan; Hopkins, Paula J.; Rosendale, James C.; Garrelts, James C.; Hale, LaDonna S.; Nester, Tina M.; Cochran, Patty; Eidem, Leslie; Haneke, Robert D.

doi:10.2146/ajhp060506

Cited by 84 publications

(69 citation statements)

References 42 publications

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“…The types and causes of medication discrepancies differed from those reported in the literature [17, [54][55][56][57][58]. This is most likely due to the fact that the majority of discrepancies in the present study were technology-related, while most published data refer to issues that are not technology-related.…”

Section: Discussioncontrasting

confidence: 76%

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Marien¹,

Legrand²,

Ramdoyal³

et al. 2017

Preprint

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Background: Medication discrepancies consist of unexplained differences between medication lists at different transition points of care; they are a threat to patient safety. These discrepancies can be solved through medication reconciliation (MedRec), a complex and time-consuming process. Several approaches to optimizing MedRec have been encouraged, including the development of information technology (IT) tools and patient engagement. The SEAMPAT project aims to develop a MedRec IT platform based on two applications (one for the patient, the "patient app", the other for healthcare professionals), which were developed using a three-iteration user-centered design. The patient app presents the patient with a medication list compiled from different medication resources. Objective: To evaluate the usability and usefulness of the third iteration of the patient app, from the perspective of different categories of users, with the aims of making recommendations for wider use and informing further research. Methods: We performed a four-month user-centered observational study. After a kick-off session, patients, identified through purposive sampling, were invited to use the patient app at home, to update their medication lists whenever required. Quantitative and qualitative data were collected at different time points to evaluate three dimensions of usability (efficiency, satisfaction, and effectiveness), as well as usefulness. Participants completed two questionnaires on satisfaction and usefulness (including the system usability scale, SUS) at the kick-off and the end of the study. Effectiveness was assessed by measuring the completeness and correctness (i.e. medication discrepancies) of the final medication list generated by the patient application. Qualitative data were collected from observations at different time points and from semi-structured interviews at the end of the study. Results: Forty-eight patients agreed to participate and 42 completed the study, of whom 32 connected at least once to the application at home. Sixty-nine percent of patients considered the patient app to be acceptable (SUS Score ≥ 70) and perceived usefulness was high. The medication list was complete for a quarter of the patients and there was a median of two discrepancies per patient. The main causes were technology-related. The qualitative data enabled the identification of several barriers and, thus, of approaches to optimizing usability and usefulness. These relate to both functional (e.g. access, on-screen display, additional functionalities) and non-functional aspects (e.g. patient awareness, concordance between patient and physician) of the application. For future adoption of the tool, it will be important to address these issues. Conclusions: Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in "real-world" conditions. We believe our study also underlines the need to take patients' points of view into consideration. To achieve adoption and sustained use by...

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Section: Discussioncontrasting

confidence: 76%

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Marien¹,

Legrand²,

Ramdoyal³

et al. 2017

Preprint

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“…Hat cikk a módszer implementációját írta le külön-böző szintű intézményekben és különböző profi lú osztályokon [23,24,25,26,27,28], tényleges gyakorlati példákat ismertetve. A közleményekben információt találtunk a bevezetés folyamatáról, az alkalmazott straté-giáról, a kap csolódó dokumentációról, a bevezetésben érintett munkaköri csoportokról, a bevezetés során tapasztalt akadályokról, azok kezelési módjairól, a gyakorlat implementációjának legfőbb tanulságairól.…”

Section: Táblázatunclassified

“…A közleményekben információt találtunk a bevezetés folyamatáról, az alkalmazott straté-giáról, a kap csolódó dokumentációról, a bevezetésben érintett munkaköri csoportokról, a bevezetés során tapasztalt akadályokról, azok kezelési módjairól, a gyakorlat implementációjának legfőbb tanulságairól. Három cikk mutatott be olyan példákat, ahol a folyamatot klinikai informatikai rendszerek is támogatják [25,26,27]. Két közlemény olyan gyakorlatot elemzett, ahol a gyógyszeres terápia egyeztetését gyógyszerész [29] vagy gyógyszerészrezidens [28] végezte.…”

Section: Táblázatunclassified

Feasibility of the implementation of medication reconciliation in Hungary

et al. 2014

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Bevezetés: A gyógyszerelé s biztonságát javító stratégiák közül a gyógyszeres terápia egyeztetése bizonyítottan eredményes, az eltérő ellátórendszerekbe és különböző profi lú osztályok gyakorlatába átültethető módszer. Célkitűzés: A gyógyszeres terápia egyeztetési folyamatának alaposabb megismerése, a gyakorlathoz kapcsolódó korlátok és hajtó-erők feltérképezése. Módszer: A szerzők irodalomkutatást végeztek. 19 adatbázisban kerestek 7 keresőmotor segítsé-gével. Két független szakértő értékelése után a releváns közleményeket előre meghatározott szempontrendszer alapján dolgozták fel. Eredmények: 230 absztraktot értékeltek. A gyakorlat bevezetésével kapcsolatban talált korlátokat és támogató erőket rendszerezték. Gyakran említett akadályként találták a kommunikációs kérdéseket, a vezetés elhivatottságának hiányát, az előre nem látható forrásigényt és a kompetenciák szabályozatlanságát. A bevezetést támogató ajánlások főként a folyamatok újratervezését, a költséghatékonysági adatok bemutatását, kapcsolódó oktatások szervezését javasolják. Következtetések: A gyógyszerelési folyamat biztonságának javítása érdekében a szerzők hazai kór-házakban is javasolják a gyakorlat bevezetési lehetőségeinek vizsgálatát az azonosított korlátok és sikertényezők alapján, a hazai intézményekben jelenleg is zajló terepgyakorlatokra alapozva. Orv. Hetil., 2014, 155(35), 1395-1405. Kulcsszavak: gyógyszerelési hibák, nemkívánatos események, gyógyszeres terápia egyeztetése, betegátadás Feasibility of the implementation of medication reconciliation in HungaryIntroduction: For medication safety improvement medication reconciliation was proven to be an effective method transferable between differe nt healthcare providers and ward profi les. Aim: Gaining a better underst anding of the process of reconciling medicines. Mapping the driving and restraining forces of introducing medication reconciliation. Method: A search of the literature was conducted. 19 databases were searched using 7 different search engines. The relevance of the papers was rated by two independent experts. Data were extracted based on a pre viously compiled extraction tool. Results: 230 articles were evaluated. Limits and driving forces of implementing medication reconciliation were set out. Often mentioned implementation obstacles were: communication issues, disengagement of the l eaders, u npredictable resources and competence problems. Recommendations mainly consisted of process redesign techniques, presentation of cost-effectiveness data and arranging special training for staff. Conclusions: For improvement of medication safety in Hungarian hospitals implementing medication reconciliation should be considered. The conclusion of ongoing on-site trials as well as limits and success factor s identifi ed in this paper should taken into account.

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“…[13][14][15][16][17][18][19][20][21][22][23] Patient safety web sites of government agencies and private organizations were also consulted for teaching materials. [24][25][26][27] The course lecture topics are listed in Table 1.…”

Section: Designmentioning

confidence: 99%

Development and Evaluation of a Required Patient Safety Course

Sukkari¹,

Sasich²,

Tuttle³

et al. 2008

Am J Pharm Educ

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Objectives. To develop, implement, and assess a required patient safety course for second-year doctor of pharmacy students. Design. A patient safety course was developed that included didactic lectures, case studies, in-class activities, and reading assignments. Written examinations and essays were used to evaluate student learning. In addition, a modified minute paper and a pre-and post-intervention student self-assessment survey were used to assess course outcomes. Assessment. Results examining the utility of the course teaching format and the relevance of the material in meeting the course outcomes are presented and discussed. The self-assessment course survey indicated major improvements in the students' knowledge and skills, readiness for knowledge application, and commitment to improve patient safety. Conclusion. The course provided pharmacy students with an increased level of understanding of the principles and concepts of patient safety.

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Implementation of an electronic system for medication reconciliation

Abstract: Patients who had their medications electronically reconciled reported a greater understanding of the medications they were to take after discharge from the hospital, including medication administration instructions and potential adverse effects.

Cited by 84 publications

References 42 publications

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Feasibility of the implementation of medication reconciliation in Hungary

Development and Evaluation of a Required Patient Safety Course

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