1. IMPROVING MEDICATION RECONCILIATION IN AN OUT- PATIENT BONE MARROW TRANSPLANT CLINIC N. Porter, APN, M. Volle, ACNP, K. Kiley, ANP, M. Payan, ANP, M. Brush, APN, S. Smith, MD, T. Rodriguez, MD, P. Stiff MD, D. Vesole, MD Confidential: Quality Improvement Material

2. The Joint Commission required implementation of medication reconciliation by January 2006 at each transitional point of care. Medication reconciliation is defined as the practice of acquiring an accurate medication history. Confidential: Quality Improvement Material

3. PROJECT AIM STATEMENT There will be an increase in compliance with out-patient medication reconciliation interviews by APNs to 90%. Confidential: Quality Improvement Material

4. MAGNET FORCES OF MAGNETISM The organization has structures and processes for the measurement of quality and programs for improving the quality of care and services within the organization. Confidential: Quality Improvement Material

5. Study Process Each APN or ANP who saw patients in clinic verbally verified and corrected each medication listed in the medication list found in EPIC Following clinic completion, an APN/ANP would verify that the medication reconciliation interview had been completed by viewing the clinic chart. Written reminders were given to APNs until the reconciliation process became standardized practice. Confidential: Quality Improvement Material

6. RESULTS Initial compliance level improved from 32% to greater than 90% and has been maintained since January, 2007. 761 charts were audited and 578 were found to be compliant. Although this represents overall compliance of 76%, the goal has been met. Confidential: Quality Improvement Material

7. Month Percent of Compliance Confidential: Quality Improvement Material

8. ANALYSIS There was a definite improvement in APN compliance with completing the medication reconciliation interview at the time of the outpatient clinic visit Confidential: Quality Improvement Material

9. NEXT STEPS Continue periodic monitoring of compliance with medication reconciliation interviews in clinic Consider refining data tool Consider increasing target level for future monitoring periods Evaluate if patients are given AVS in clinic containing an updated medication list Confidential: Quality Improvement Material