Implementing medication reconciliation from the planner's perspective: a qualitative study.

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Implementation science

Background:

• Medication reconciliation is a key strategy to reduce adverse events from prescribing errors during care transitions.
• Despite being a Joint Commission National Patient Safety Goal since 2006, widespread implementation challenges persist.
• This study explored facilitators and barriers to medication reconciliation planning from the perspective of involved individuals.

Purpose of the Study:

• To identify recurrent themes in medication reconciliation implementation planning.
• To provide insights for other organizations planning and executing medication reconciliation initiatives.
• To understand the perspectives of those involved in the planning process.

Main Methods:

• Semi-structured interviews were conducted with 13 individuals involved in planning medication reconciliation at an academic medical center and its VA hospital.
• Grounded theory approach was used to code and analyze interview transcripts.
• Emergent themes were categorized using the Consolidated Framework for Implementation Research (CFIR).

Main Results:

• The planning process was resource- and time-intensive, with team composition and function being critical.
• Understanding performance improvement principles and integrating the process into existing workflows facilitated implementation.
• Significant professional role changes and limitations in staff training were identified as challenges.
• Compliance monitoring did not guarantee the primary goal of error reduction was met.

Conclusions:

• Successful medication reconciliation implementation necessitates multidisciplinary planning teams.
• Acknowledging and addressing potential professional role changes is crucial.
• Resource allocation should extend beyond compliance monitoring to evaluating the process's impact on prescribing accuracy.