London Transfer Project: Reducing Medication Incidents After Discharge From Hospital to Long-term Care

Area of Science:

• Health Services Research
• Patient Safety
• Medication Management

Background:

• Long-term care (LTC) facilities reported medication incidents in patients post-hospital discharge due to poor care coordination.
• These incidents highlight a critical gap in the communication process between hospitals and LTC homes.

Purpose of the Study:

• To reduce medication incidents in LTC by 50% within 48 hours of hospital discharge.
• To improve the coordination of care during patient transfers from general medicine units.

Main Methods:

• A quality improvement study in London, Ontario, Canada, involving 2 hospitals and 5 LTC homes.
• Implemented two key interventions: expediting medication reconciliation and faxing medication plans before discharge.
• Evaluated changes using time-series analysis, comparing baseline and intervention periods via dual chart reviews.

Main Results:

• Medication incidents significantly decreased by 56% (from 44% to 19%, P=.006) within 48 hours of discharge.
• Faxes of medication plans before discharge significantly increased from 4% to 67% (P=.015).
• Medication reconciliation completion by noon showed a non-significant increase (56% to 74%, P=.076).

Conclusions:

• A systems approach to redesigning communication processes effectively reduces medication incidents during care transitions.
• The successful interventions are planned for scaling to other inpatient services with high LTC resident populations.