One of my passions is improving medication safety outcomes through interprofessional team collaboration and partnering with patients, especially as it relates to medication reconciliation (MedRec) in hospital settings.
As hospitals and patient care continue to become more complex, MedRec must move away from simply being a siloed “administrative accounting task” and move towards being a key part of systematic, bundled, conscientious, and patient-centred clinical medication management intervention that enhances patient safety.
An effective MedRec process considers the who, what, where, when, and how:
- Who should receive MedRec (all admitted patients or “high-risk” patients only)?
- Who should optimally lead MedRec activities at each interface?
- What are the patient outcomes of interest?
- Where should hospitals implement MedRec (on medical and surgical wards versus ambulatory clinics)?
- When should MedRec occur (during admission, discharge, internal transfers and ambulatory visits)?
- How should MedRec occur (on paper or electronically)?
Some of the evidence related to these important questions are summarized in the article Medication Reconciliation in the Hospital: What, Why, Where, When, Who and How?
From a national hospital pharmacy perspective, another useful tool when considering the quality and effectiveness of your MedRec process as part of an effective interprofessional medication management program is the Canadian Consensus on Clinical Pharmacy Key Performance Indicators: Quick Reference Guide.
This guide outlines clinical pharmacy key performance indicators (cpKPIs) that are intended to improve the quality of clinical pharmacy care and ultimately meaningful patient outcomes. Pharmacists can partner with interprofessional teams and patients to improve meaningful patient outcomes such as reducing readmissions.
The eight cpKPIs in the patient journey during hospitalization are outlined below.
The key message is that individually, each cpKPI measures a certain set of essential patient care activities, with the understanding that these activities are connected to the larger medication management process.
MedRec should be part of a “bundle” of integrated medication management patient care activities to ultimately improve meaningful patient outcomes.
Please comment below on how you and your organization are ensuring safe medication management for your patients! I’d love to hear from you!
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