An On-Treatment Analysis of the MARQUIS Study: Interventions to Improve Inpatient Medication Reconciliation

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Medication Management

Background:

• Medication discrepancies are a significant challenge in inpatient care.
• Identifying effective interventions for medication reconciliation is crucial for patient safety.

Purpose of the Study:

• To evaluate the effectiveness of various medication reconciliation interventions in reducing inpatient medication discrepancies.
• To identify which interventions lead to significant decreases or increases in potentially harmful discrepancies.

Main Methods:

• Five US hospitals' interdisciplinary quality improvement (QI) teams implemented 1-7 evidence-based interventions.
• Virtual mentorship by QI-trained physicians guided the implementation over 25 months.
• Data were collected on 791 patients to assess discrepancy rates.

Main Results:

• Defining clinical roles, staff training, and hiring dedicated discharge reconciliation staff significantly decreased discrepancies.
• Training for medication histories and implementing new electronic health records (EHRs) were associated with increased discrepancies.
• Specific interventions showed varied impacts on medication error rates.

Conclusions:

• Hospitals should prioritize hiring pharmacy staff for discharge reconciliation and clarifying staff roles.
• Caution is advised when implementing large vendor EHR systems due to potential increases in discrepancies.
• Further research is needed to understand the impact of medication history training on discrepancies.