Rationale and design of the Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS).

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Medication Management

Background:

• Unresolved medication discrepancies contribute to adverse drug events and patient harm.
• Effective implementation of medication reconciliation is challenging.
• The Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) addresses these challenges.

Purpose of the Study:

• Operationalize best practices for inpatient medication reconciliation.
• Test the effect of these practices on unintentional medication discrepancies.
• Understand barriers and facilitators to successful implementation.

Main Methods:

• A mentored implementation study involving six U.S. hospitals.
• Collection of baseline data on medication discrepancies by trained pharmacists.
• Mixed methods program evaluation including surveys, interviews, and focus groups.

Main Results:

• Baseline unintentional medication discrepancies range from 2.35 to 4.67 per patient.
• Most discrepancies stem from history errors (mean 2.12 per patient).
• Potentially harmful medication discrepancies average 0.45 per patient.

Conclusions:

• MARQUIS identifies barriers to implementing medication reconciliation best practices.
• Anticipated outcomes include decreased medication discrepancies.
• The study aims to improve patient safety and outcomes through lessons learned.