For my residency project, I am working with Dr. Anita Lo (Principal/Coordinating Investigator) along with Mark Collins, Janice Munroe, Laura Drozdiak (Co-Investigators). Dr. Anita Lo is the Medication Reconciliation Facilitator for Fraser Health. Our project’s focus is to compare percent medication discrepancies identified with the use of a blank form vs. a pre-populated form.
Below is the abstract of our study so far:
Medication Reconciliation is a formal process designed to prevent patient harm by comparing patient’s medication history with the medication orders written by physicians. The Canadian Council on Health Services Accreditation endorses the implementation of medication reconciliation as part of their Patient Safety Goals and Required Organizational Practices released in 2005. If fully integrated into daily practice, the process can enhance patient care by reducing medication errors. At present, majority of the sites in Lower Mainland Pharmacy Services are using blank forms. A pre-populated form would be introduced at Peace Arch Hospital in September 2011. The intent of our study is to compare percent medication discrepancies with each kind of form (blank vs. pre-populated). The secondary outcomes are to compare time to collect medication history, healthcare workers’ satisfaction using a survey, and compliance of healthcare workers with the reconciliation process (percent of charts with a complete medication reconciliation form within 24 hours of admission) and to examine the causes of variations over time.
I have finished the protocol, submitted the Ethics application and Data Access Agreement application. The Ethics application and Data Access Agreement have been approved. The next step is to start collecting data. We would start collecting the data in September. It only gets more and more intense from here on! Yay! I will keep adding to this more as I start collecting data and observe any differences.
RESIDENCY PROJECT PROGRESS PRESENTATION
Things that have changed:
1. We would not longer be comparing the time it takes to collect medication history as each patient is going to be different. Some patients would be complicated and it would naturally take longer to complete the medication reconciliation process for them.
2. Suggestions from other project coordinators present during the presentation: It would be better to exclude patients with cognitive impairment from our study unless there is a reliable drug information source i.e. family member or medication vials from home to verify medication history.
3. We are still exploring statistics for this project. I need to understand Statistic Process control method.
Questions asked during presentation I did not have clear answers to: What is our hypothesis? So far we don’t have one but it would be ideal to state the baseline level and medication discrepancy rate we are expecting.
Issues: Study by Steve Shalansky et al. determining the accuracy of PharmaNet for Medication Reconciliation for Outpatients with Heart Failure found that discrepancies between the PharmaNet profile and the
interview-based prescription medication history were identified for 71.1% patients. Therefore, the best way to perform medication reconciliation is to best possible medical history.
If a physician has written all the medications patient was on in the history section of the chart by consulting PharmaNet, what if other health professionals follow it blindly without interviewing the patient.
Final presentation at CSHP Residency Project Presentation Night
Residency Project Presentation RMinhas