Accurate medication information is essential to providing safe and effective care. It can be challenging to determine what medications a patient takes at home and ensure an up-to-date list is kept in the electronic health record. Hospitals have integrated pharmacy into the admission medication reconciliation process in emergency department and preoperative phone calls. A comprehensive approach for all hospitalizations is often lacking. Limited literature is available regarding solutions for ambulatory clinics.
At Children’s Wisconsin, a large multidisciplinary clinical and support team was involved in this project, including medical and surgical providers, nursing staff, pediatric residents, pharmacists, pharmacy leadership, a parent and the following hospital departments: information management systems, provider services, patient safety and performance improvement.
Pharmacy was integrated into the admission medication reconciliation process by completing medication histories on patients being hospitalized through the emergency room or pre-operative areas and throughout the hospital to reach the remaining patients. Pharmacy completes medication histories on more than 90% of all hospitalized patients resulting in the home medication list being 98% accurate. This change also resulted in a 98.5% reduction in the number of hospital home medication orders requiring interventions, 90% of discharge medication lists being accurate and 90% of after-visit summaries being clear and without confusing information.
In the ambulatory clinics, targeted one-on-one training/coaching for R.N.s and M.A.s resulted in 80% of patients having all the medications listed on the home medication list and 90% of the medications managed by the clinic being complete and accurate. Children’s Wisconsin is currently going systematically through each of the ambulatory clinics to provide the training/coaching.
“Children’s Wisconsin has demonstrated another successful way that team-based care can be deployed to tackle the challenge of medication safety. It is a tribute to the culture of collaboration that Wisconsin’s high-quality health care is known for, ensuring Wisconsin can maintain our ranking as one of the best states in the country to receive health care.”
Sen. Dale Kooyenga (R-Brookfield)
View Children’s Wisconsin’s poster detailing this project here