Medication Reconciliation Improvement Utilizing Process Redesign and Clinical Decision Support.

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Clinical Informatics

Background:

• Hospitals face persistent challenges in implementing effective medication reconciliation processes.
• Successful medication reconciliation is crucial for patient safety and preventing adverse drug events.

Purpose of the Study:

• To increase hospital admission medication reconciliation (AdmMedRec) completion rates to at least 95% within 12 months.
• To sustain high rates of medication reconciliation in a pediatric academic hospital setting.

Main Methods:

• A quality improvement project utilized interdisciplinary teams and Plan-Do-Study-Act cycles.
• Interventions included EHR workflow redesign, clarified responsibilities, targeted training, and performance feedback.
• Failure mode and effects analysis and process mapping identified key areas for improvement.

Main Results:

• AdmMedRec completion increased from 73% to 95% within 7 months and was sustained at 94%.
• Significant improvements were observed in Psychiatry (17% to 88%) and hospital medicine (76% to 98%).
• Reconciliation rates for all 13 therapeutic drug classes, including high-risk medications, improved significantly (p < 0.05).

Conclusions:

• An interdisciplinary quality improvement initiative successfully enhanced hospital admission medication reconciliation rates.
• Process and culture changes were key to improving medication reconciliation and reducing omission errors.
• The project demonstrated sustained success in medication reconciliation across diverse therapeutic drug classes.