Differences in medication reconciliation interventions between six hospitals: a mixed method study.

Area of Science:

• Healthcare Management
• Clinical Pharmacy
• Patient Safety

Background:

• Medication reconciliation (MedRec) is mandated to reduce medication errors during care transitions.
• Hospitals exhibit variability in their implementation of MedRec processes.

Purpose of the Study:

• To quantitatively compare MedRec interventions (discrepancy resolution and pharmacotherapy optimization) between hospitals upon admission and discharge.
• To qualitatively explore reasons behind observed differences in MedRec intervention rates.

Main Methods:

• A retrospective mixed-method study involving six hospitals across various wards.
• Quantitative analysis of pharmacy interventions (discrepancies and optimizations) and qualitative analysis of focus group interviews.
• Inclusion of patients undergoing MedRec on hospital admission and discharge.

Main Results:

• Significant variation in the percentage of patients receiving MedRec and experiencing discrepancies/optimizations between hospitals.
• Higher intervention rates for discrepancies on admission (36-95%) compared to discharge (5-28%).
• Wide range of pharmacotherapy optimizations, from 2% on admission to 95% on discharge, influenced by patient mix, professional roles, and process execution.

Conclusions:

• Hospital MedRec intervention numbers vary considerably due to differences in execution and local context.
• Findings highlight the impact of implementation strategies and contextual factors on MedRec effectiveness.
• Provides data to support hospitals in optimizing their MedRec processes for improved patient safety.