1. 1 Western Node Collaborative BC Children’s Hospital Medication Reconciliation Penticton – October 2006

2. 2 continued……… Background BC Children’s Hospital – part of Children’s & Women’s Health Centre of BC Multidisciplinary team (RN, MD, Pharmacist, QS&RM, Family Rep) Emergency Department (ED) with spread to Oncology Clinic Oncology Inpatient Unit then site-wide Start December 2005 and end December 2006

3. 3 Aligns with Provincial Health Services Authority Strategic Plan which states that “we must implement systems and processes that ensure safe clinical and work environments ”. Med Rec and Accreditation – Patient Safety Goals Project led by Department of Quality, Safety & Risk Management; team members from each clinical area join and leave the team as initiative spreads. Background

4. 4 Aim Purpose: to prevent adverse drug events at BCCH by implementing a medication reconciliation process. Goals/Objectives or Aim Statements: To reduce the number of: a) undocumented intentional discrepancies & b) unintentional discrepancies at admission by 95% by December 2006.

5. 5 Team Members Emergency - Physician (Quality Initiatives), Educator, Charge Nurse, Quality & Safety Coordinator Oncology Clinic and Inpatient Unit Physician, Nurse Educators and Clinicians Quality Safety & Risk Management Pharmacy Family Representative Decision support Communications

6. 6 Changes Tested Emergency - form trialed by Educator in different places : Triage desk (no time) Fast Track area (very few admissions) Family completing form (too stressed) In the cubicle area of ED after order to admit received (adopted) Oncology Clinic - form trialed by Oncology staff nurse who first used the form then taught clinic nurses to complete it (very successful)

7. 7 Keys to Success & Lessons Learned Ask unit leadership and staff how they would best like to proceed with implementation Obtain buy-in from unit (Physician, Nursing Leadership, Pharmacy) Find unit staff to act as a champion and able to provide one-to-one training Remain flexible in scheduling meetings and maximize use of electronic communication tools

8. 8 Next Steps and Plans for Spread Confirm education plans for ED and Oncology Train staff re: completion and use of Medication History form and reconciliation process Finalize generic Power Point Presentation with video clips from staff and families Laminated poster for clinical areas

9. 9 continued……. Next Steps and Plans for Change Explore electronic and paper discharge forms already in use Consider how electronic tools can support the medication reconciliation process long term Standardize Discharge Form as much as possible for parents to use when/if readmitted. Close the Loop!

10. 10 Contact Information Judy Komori, Leader Quality & Safety jkomori@cw.bc.ca. 604.875.2105jkomori@cw.bc.ca Anne Compton, Leader, Quality & Safety acompton@cw.bc.ca 604.875.2345 local 7002 acompton@cw.bc.ca Denise Hudson, Emergency Quality Initiatives dhudson@cw.bc.ca 604.875.2354 local 5341dhudson@cw.bc.ca Irene Matsui, Leader, Quality & Safety imatsui@cw.bc.ca 604.875.2354 local 6261imatsui@cw.bc.ca