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Medication Reconciliation Strategies to Reduce Hospital Adverse

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Medication Reconciliation Strategies to Reduce Hospital Adverse
Drug Events

Description:    Patient injuries resulting from drug therapy are among the most common types of adverse events
                that occur in hospitals. According to the Agency for Healthcare Research and Quality, adverse drug
                events (ADEs) result in more than 770,000 injuries and deaths each year and cost up to $5.6
                million per hospital, depending on size. Hospitals can reduce the number of ADE injuries and
                related costs by taking steps to prevent and detect ADEs.

                Improving medication delivery and adopting a safety culture has significantly improved the quality
                of care at McLeod Regional Medical Center, a 453-bed flagship hospital for the three-hospital
                McLeod Health System. McLeod has revamped its medication delivery process to significantly
                reduce harmful events and medication turnaround times and changed its culture of "blame"
                associated with these events to one of openness and support.

                In this special report, "Medication Reconciliation Strategies to Reduce Hospital Adverse Drug
                Events," Donna Isgett, McLeod vice president for clinical effectiveness, describes the hospital's
                emphasis on quality and perfect care processes, while Leanne Huminski, chief nursing officer,
                provides the inside details on McLeod's medication management program, which has a goal of
                eliminating adverse drug events.

                In this 30-page report, Isgett and Huminski describe the development of their medication
                reconciliation plan, including:

                -   Identifying success factors of a healthcare quality improvement system;
                -   Creating a vision plan to enlist staff and C-suite support;
                -   Building a culture of safety, including education, communications and training;
                -   Streamlining medication delivery;
                -   Using healthcare technology and automation;
                -   Communication of drug information during patient admissions, transfers and discharges;
                -   Developing new models of monitoring and reporting errors;
                -   Communicating risk/benefit information;
                -   Engaging physicians in the use of support technology;

                and much more.

                A reproducible copy of the two-page Universal Medication Form in use at McLeod is included in this
                report, along with sample forms for chart review, adverse event summaries, transfer medication
                summaries and medication assessment histories/physician orders.

                The medication management program at McLeod Health was funded in part through a grant from
                Pursuing Perfection: Raising the Bar for Health Care Performance, a $21 million initiative sponsored
                by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement
                (IHI), an internationally recognized leader in healthcare quality.

                This report is based on a 2007 audio conference on pursuing perfect care for the chronically ill by
                focusing on the whole patient.



Contents:       - Core Success Factors of a Healthcare Quality Improvement System

                Engaging Physicians and the C-Suite

                - Linking Quality of Care and Medication Safety

                Changing the Culture of Blame Surrounding Medication Safety
                Creating a Culture of Safety
            Engaging and Empowering Staff
            The Roles of Communication, Collaboration
            Reducing the Steps in the Medication Delivery Process
            Technology and Automation Critical to Change Process
            Medication Reconciliation Goals
            The Discharge Reconciliation
            Reviewing Program Accomplishments

            - Appendix: McLeod Regional Health Center Medication Reconciliation Forms

            Medication Adverse Event Summary Form
            ADE/AE Chart Review Tool
            Transfer Med Summary Order Form
            Medication Assessment History/Physician Order Form
            Universal Medication Form

            - Q&A: Ask the Experts

            Identifying & Dealing with Workarounds
            Educating Patients & Providers on the Universal Medication Form
            Improved Medication Management System Ready For Launch
            Physician Engagement Strategies
            Developing the Universal Medication Form
            Physician Engagement Strategies

            - Glossary
            - For More Information
            - About the Authors



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Description: Medication Reconciliation Strategies to Reduce Hospital Adverse