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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;
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Streamlining medication delivery;
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Using healthcare technology and automation;
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Communication of drug information during patient admissions, transfers and discharges;
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Developing new models of monitoring and reporting errors;
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Communicating risk/benefit information;
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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.
Table of Contents
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Core Success Factors of a Healthcare Quality Improvement System
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Engaging Physicians and the C-Suite
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Linking Quality of Care and Medication Safety
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Changing the Culture of Blame Surrounding Medication Safety
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Creating a Culture of Safety
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Engaging and Empowering Staff
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The Roles of Communication, Collaboration
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Reducing the Steps in the Medication Delivery Process
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Technology and Automation Critical to Change Process
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Medication Reconciliation Goals
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The Discharge Reconciliation
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Reviewing Program Accomplishments
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Appendix: McLeod Regional Health Center Medication Reconciliation Forms
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Medication Adverse Event Summary Form
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ADE/AE Chart Review Tool
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Transfer Med Summary Order Form
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Medication Assessment History/Physician Order Form
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Universal Medication Form
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Q&A: Ask the Experts
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Identifying & Dealing with Workarounds
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Educating Patients & Providers on the Universal Medication Form
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Improved Medication Management System Ready For Launch
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Physician Engagement Strategies
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Developing the Universal Medication Form
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Physician Engagement Strategies
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Glossary
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For More Information
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About the Presenters
