Improving pre-operative medicines reconciliation

Area of Science:

• Surgery
• Pharmacology
• Patient Safety

Background:

• Incomplete medication charts in surgical patients lead to missed doses of essential medications post-operatively.
• Pre-operative assessment clinics (POAC) are crucial for medication reconciliation, yet completion rates vary significantly between surgical and orthopaedic patient groups.

Purpose of the Study:

• To investigate interventions aimed at improving drug chart completion rates by junior doctors in the POAC.
• To identify barriers to junior doctor attendance and participation in POAC sessions.

Main Methods:

• A prospective study over 22 weeks in the POAC, implementing three interventions to improve drug chart completion.
• Data collection included drug chart completion rates, junior doctor attendance at POAC, and reasons for absence.
• Run charts were used to track daily and weekly completion percentages.

Main Results:

• Baseline drug chart completion was 43%, rising to 51% after three interventions, still below the 94% target.
• Junior doctors attended only 44% of POAC sessions, citing being "too busy" as the primary reason.
• Interventions did not significantly improve drug chart completion rates.

Conclusions:

• Current resources and junior doctor availability are insufficient to improve drug chart completion in POAC.
• Employing prescribing pharmacists in POAC for general surgery and urology patients is recommended to ensure complete medication charts and enhance patient safety.