1. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Background Pilot project done with respite admissions to 2 Personal Care Homes (PCH) using the Home Medication and Initial Orders (HMIO) form early 2007 Joined Western Node Collaborative of SHN April 2007 Education occurred for new site specific policy and use of HMIO form in Rideau Park (June) & Fairview (August) PCH Implementation dates for new admission process –Rideau Park June 19 th –Fairview August 23 rd

2. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Aims Aim Statements for Long Term Care –To reduce unintentional discrepancies by 90% on admission to PCH by May 2008 –To reduce undocumented intentional discrepancies by 90% on admission to PCH by May 2008

3. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Team Members Mary Lou Lester – Pharmacist & Team Leader Tracey Anderson – Resident Care Manager (Rideau Park) Kristi Chorney – Quality/Risk Management Dr. Groves – Physician Liaison Sheldon Kokorudz – Pharmacy Director Liliana Rodriguez – Planning/Evaluation

4. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Long Term Care Working Group Cindy Smith/Lori Nevins – Resident Care Managers Christine Machado – Rideau Park educator Jean Robson – Fairview Educator Cheryl Bourdeau D’Hui/Trudy Curtis – Coordinator Resident Services Bonnie Coombs – contract pharmacist Nestor Atamanchuk

5. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Changes Tested Trial of Home Medication and Initial Orders (HMIO) for all respite admissions to PCH Trial of HMIO for 1 admission at Fairview to test new site specific policy for admission Assisted Home Care working group with Universal Medication Form (UMF) trial for respite admissions

6. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Results Baseline data Mean Number of Undocumented Intentional Discrepancies -- 0 Mean Number of Unintentional Discrepancies -- 1.6 Medication Reconciliation Success Index -- 86% Rate of potential harm -- 43%

7. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Keys to Success & Barriers Keys to Success –Co-operation of contract pharmacist to complete BPMH for data collection –One of the first admissions post-implementation at Rideau Park saw the HMIO help prevent several potential discrepancies – staff buy-in Barriers –Lack of on-site pharmacist within PCH –Low number of admissions extended the amount of time required to collect baseline data

8. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Lessons Learned & Next Steps Lessons Learned –Timeline for an identical project will vary from facility to facility Education of staff Admission rate Staff involvement Next Steps –Discuss the current 3 month review (done by contract pharmacist & physician) –Discuss the current process for residents sent to BRHC for acute care

9. Coming Full Circle: AMI & Med Rec Across the Continuum Western Node Collaborative Contact Information Tracey Anderson –andersont@brandonrha.mb.caandersont@brandonrha.mb.ca Mary Lou Lester –lesterm@brandonrha.mb.calesterm@brandonrha.mb.ca