Implementation strategies in the context of medication reconciliation: a qualitative study

Area of Science:

• Healthcare implementation science
• Patient safety research
• Health services research

Background:

• Medication reconciliation (MedRec) is crucial for patient safety, aiming to prevent harm from medication errors.
• Implementation challenges include poor interprofessional communication and limited organizational capacity.
• Optimal MedRec implementation strategies remain unclear.

Purpose of the Study:

• To describe implementation strategies used by hospitals to implement the MARQUIS Medication Reconciliation Toolkit.
• To evaluate the utility of the Expert Recommendations for Implementing Change (ERIC) taxonomy in guiding MedRec implementation.

Main Methods:

• A qualitative study involving implementation teams and leaders from 16 hospitals.
• Data collected via focus groups, interviews, and meeting minutes.
• Content analysis and constant comparison technique used for data analysis.

Main Results:

• Implementation strategies largely aligned with ERIC categories: Plan, Educate, Restructure, and Quality Management.
• Fewer strategies utilized finance and policy context.
• New categories of "Integration" and "Professional roles and responsibilities" emerged, alongside 11 novel strategies.

Conclusions:

• The ERIC taxonomy is beneficial for complex interventions like MedRec toolkits.
• Adaptations and new strategies beyond ERIC are necessary for comprehensive implementation.
• Understanding diverse implementation approaches enhances successful adoption of patient safety initiatives.