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Medication Reconciliation
Dept of Family Medicine and Community Health Bethesda, Broadway, Phalen, Smileys Clinics Nov 8, 2018
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Disclosures No funding disclosures
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Quality Gap Patient safety Medication reconciliation seldom done
<5% of visits with documented medication reconciliation MIPS measure
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Aim / Measures Aim By Sept , implement a systematic medication reconciliation process and document provider or pharmacist medication reconciliation* on 70% of patient visits. * Med reconciliation defined as the process of identifying the most accurate list of medications that a patient is taking. This includes name, dosage, frequency, and route. The list should include all known prescriptions, OTC, herbals, and vitamin/mineral/dietary(nutritional) supplements. Measures % visits with med rec documented by provider or pharmacist (outcome) % visits with attempted med rec documented by PCS staff (process) % staff/providers able to articulate med rec process (process) % staff/providers satisfied with med rec process (balance)
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Interventions Design a team-based med reconciliation process (June-Oct 2017) -- Multiple PDSAs -- Process flow diagram -- Pilots (Aug-Oct 2017) 2. Training and implementation (Nov/Dec 2017) 3. Re-education / training (July 2018) 4. Satisfaction surveys (June 2017, May 2018, Sept 2018)
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Intervention - Process Flow Diagram (1)
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Intervention - Process Flow Diagram (2)
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Interventions – Examples of PDSAs
Medication review methodology by PCS – PDSAs Paper method EMR – Meds section EMR – Orders section EMR – Home meds section
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Outcomes Re-education Training Pilots
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Sustain / Spread Sustain Spread Standard work written
Supervisor audits for PCS Monthly data Review data quarterly at FaMQIC Intervene if needed Spread Presenting at STFM Practice Improvement Conference (Dec 2018)
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