Over an 18-month period from 2016 – 2017, the Minnesota Hospital Association (MHA) convened a multidisciplinary work group to develop a medication reconciliation road map with funding from the Cardinal Health Foundation. The 24-item checklist is an excellent tool to find gaps in current processes, and it is a source for many medication reconciliation resources. Prior to finalizing the road map, several hospitals implemented it as part of a medication reconciliation (med rec) quality improvement project.
Two of those hospitals shared their implementation experiences at the annual MHA medication safety conference in August 2018. The slide handout and video of this panel presentation are available online.
St. Luke’s Hospital, a 267-bed level II trauma hospital in Duluth, MN and River View Hospital, a 25-bed critical access hospital both had representatives share their experiences. Some themes and lessons learned emerged:
- Medication reconciliation processes were faulty in both facilities.
- Both organizations had leadership support for quality improvement around med rec policies and practices.
- Multidisciplinary teams were formed to review practices and policies and to develop new processes at both facilities.
- Early discussions centered on who owns which part of the process.
- It was critical to define not just who was doing the work, but what was being done.
- Both teams found the need to develop electronic health record (EHR) enhancements. Luke’s, for example, made sure that every person responsible for a piece of the med rec process has the same view of medications in their EHR (Meditech).
- The road map served as a guide for both facilities to review and revise policies, practices, and processes.
- Patients often don’t know their role in maintaining their own med lists, and many incorrectly assume their med histories are available to providers.
- Lack of standardized processes and education leads to rework when physicians don’t trust the work of the person who obtained a med history.
- Nearly 10 months after they began the road map pilot project, both teams report that the work to improve med rec is ongoing.
Medication reconciliation is one of the biggest challenges facing health care teams. We’ve developed a tool to help guide hospitals in a med rec improvement project. To get started, gather three things: a multidisciplinary improvement team, leadership support, and the MHA road map.
For more information or to share your experience using the MHA road map, please contact Joy Benn, quality and process improvement specialist at MHA.
Joy Benn, MBA
Quality and Process Improvement Specialist
Minnesota Hospital Association