1. Medicine Reconciliation Network Pamela Mills Principal Pharmacist – Redesign SPSP Fellow Vice Chair Medicine Reconciliation Network

2. Scottish Patient Safety Programme Rolled out to all Acute hospitals in 2008 5 key workstreams –Leadership –Critical Care –General Ward –Peri-operative –Medicines Management Reduce mortality by 15% Reduce adverse events by 30%

3. Medicine Reconciliation 3 Key Stages –Admission –Transfer –Discharge Measure: 95% within 24 hours

5. Reconciliation Acute Adult Paediatric Mental Health 2012 Primary Care 2012

6. Medicine Reconciliation Network Multiprofessional reference network –Synergy and support –Sharing of best practice and wicked problems –Testing new ideas –Looking for solutions to share Established Sept 2011

7. Challenges Multiple professions involved Information available Time to complete accurately Admission rates Prescribing errors Transcription/ duplication Scotland and rest of world

8. Patient Entry Routes GP Referral Self Present 999 Ambulance ADOC NHS 24 Pre-op clinic

9. Medicine Reconciliation Process Medication history Medicine Reconciliation Inpatient prescription sheet

10. Emergency Care Summary (ECS)

14. ECS Med Rec Report

15. Challenges Med Rec report not “user friendly” Not consistent process – access & printing Accuracy of information Certain medicines not included

16. Redesign of ECS Report Patient Name, CHI, DOB Patient name on all pages Allergies Medicines in alphabetical order Remove dressings, catheters, needles etc Comments column Space under each row- changes 10 empty rows at bottom Compliance aid Details of completion

17. Scotland Consultation Health BoardAgreement? Ayrshire and ArranYes BordersYes Dumfries & GallowayN/A FifeYes Golden JubileeN/A GrampianYes Greater Glasgow & ClydeYes HighlandsYes LanarkshireYes LothianYes OrkneyN/A ShetlandN/A TaysideYes Western IslesN/A 24Yes

18. Feasibility? Patient name on all pages - 02/11/11 Alphabetical order- local filter Remove non-drugs- not possible Everything else – March 2012