Utilising improvement science methods to optimise medication reconciliation.

Area of Science:

• Healthcare Improvement Science
• Patient Safety Research
• Reliability Engineering in Healthcare

Background:

• Medication reconciliation is a National Patient Safety Goal established in 2005 to minimize medication errors.
• Hospitals face ongoing challenges in effectively implementing medication reconciliation programs.

Purpose of the Study:

• To develop and implement a sustainable medication reconciliation process at admission.
• To improve the timely and accurate completion of medication reconciliation in a pediatric medical center.

Main Methods:

• Utilized improvement methods and reliability science principles.
• Defined medication reconciliation as nurse recording within 20 minutes and physician reconciliation within 24 hours of admission.
• Focused interventions on leadership, electronic application standardization, role clarification, system reliability, and sustainability.

Main Results:

• Achieved over 90% medication reconciliation within 24 hours of admission, up from a baseline of 62%.
• Sustained high performance for 27 months.
• Demonstrated successful implementation in a large, busy academic children's hospital.

Conclusions:

• Improvement methods and reliability science enabled the creation of a sustainable medication reconciliation process.
• Successfully addressed medication reconciliation completion at admission in a pediatric setting.