Improving Medication Reconciliation compliance at admission

Abstract

Background and objectivesThe objective of this research is to improve compliance of the medication reconciliation process at the time of patient admission in the Department of Pediatrics at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia using an innovative evidence-based approach.Materials and methodsMost of the recent efforts at our institution to revamp the medication reconciliation process have failed. Thus, we implemented an innovative evidence-based approach to improve the compliance of the reconciliation process at admission. This approach focused on the Department of Pediatrics at King Faisal Specialist Hospital and Research Centre (KFSH&RC). We established specific educational and monitoring programs that were run over a two-month period, from June to July 2015. The educational program consisted of focused hands-on daily interactive training sessions presented to a small group of residents, i.e., 5–6 residents per session, for a period of one week. One resident was identified as a ”Super-User” to provide ongoing support for the other residents involved in the process. A close monitoring process was also implemented, which included daily follow up and encouragement from three assigned consultants. In addition, periodic independent audit report results prepared by Healthcare Information Technology Affairs (HITA) were communicated to the Department of Pediatrics regarding physician compliance in the medication reconciliation process.ResultsPhysician compliance for admission medication reconciliation documentation in ICIS ranged from (0–15%) between the first quarter of 2012 and the first quarter 2015, we designated the official hospital audit for the first quarter of 2015 as a baseline audit report. Between the first quarter of 2012 and 2015, the physician compliance for admission medication reconciliation was ranged between 0 to 15% according to the official hospital audit. We implemented our initiative during the months of June and July 2015. During that time, there was a gradual improvement in the number of admission medication reconciliations reported by the independent audits of our general Pediatrics Ward (B1), which represents the majority of pediatric admissions. The 57% of 26 patients had medication reconciliation completed by the first report dated 16 June 2015. This percentage improved to 92% out of a total of 13 patients at the last report on 12 July 2015. This consistent improvement also occurred in other areas where pediatric patients were admitted including the B3-1 (from 88% to 90%), the NICU 1 (from 83% to 100%) and the NICU 2 (from 90% to 100%).ConclusionsBy structuring and implementing intensive educational and monitoring programs, a marked improvement in the compliance of medication reconciliation at the time of admission for the pediatric patient population was achieved. We believe that our department-based results would be generalizable if a similar hospital-wide programme was to be rigorously implemented.

Completeness of Medication Reconciliation by Pediatric Residents at Hospital Admission for Asthma

“…Although educational interventions have been of limited effectiveness, 6 certain individual centres have had success in reducing medication discrepancies by increasing the education of medical residents. 7,8,18 At our institution, increasing resident education to include the full and ongoing process of medication reconciliation, rather than just the technical aspects of completing a BPMH on a preprinted order form, may be of benefit. Mandating access to provincial electronic drug information systems for prescribers, as well as partnering with clinical pharmacists and pharmacy technicians at the time of admission, to facilitate communication with patients' community pharmacies, would result in more complete medication histories.…”

“…Our literature review of medication reconciliation education initiatives targeted toward resident physicians found limited published data on the best way to approach this training. [6][7][8][9][10] Medication reconciliation data for pediatric asthma are limited, as are data assessing the accuracy of medication reconciliation performed by medical residents, given that most studies to date have evaluated pharmacy-led initiatives. 11 Therefore, this study aimed to assess the completeness of medication reconciliation forms prepared by resident physicians for pediatric inpatients with asthma.…”

Researching on the compliance of epilepsy patients of the Phenobarbital Epilepsy Management Project in a rural area of China

“…Antiepileptic treatment should also be considered for patients with other medical conditions or active epilepsy who do not meet the inclusion criteria. [ 21 ] When necessary, local neurologist experts can be consulted to determine the treatment plan. The treatment and management of such patients can be developed in various localities according to the actual situation.…”

“…Patients who meet the inclusion criteria (and are not excluded from the exclusion criteria) and wish to participate may be enrolled for treatment. Antiepileptic treatment should also be considered for patients with other medical conditions or active epilepsy who do not meet the inclusion criteria [21] . When necessary, local neurologist experts can be consulted to determine the treatment plan.…”

Journey of medication reconciliation compliance in a lower middle-income country: a retrospective chart review

“…7 Another study showed that hands-on interactive training sessions, close monitoring, reinforcement by assigned physicians and audit reports in a hospital in Saudi Arabia improved admission medication reconciliation remarkably in 2015. 4 A hospital in Abu Dhabi improved its medication reconciliation compliance from 40% to 85% in 2014-2015 over 15 months by sharing daily audit reports of admission medication reconciliation, awareness and education regarding filling of online reconciliation forms, mandatory electronic hands-on training for the newly hired physicians for filling the forms and screening of all admissions for medication reconciliation the following morning. 8 Studies indicate that medication reconciliation performed by a clinical pharmacist can significantly reduce medication discrepancies.…”