"Let's Chat!" Improving Emergency Department Staff Satisfaction with the Medication Reconciliation Process

Area of Science:

• Emergency Medicine
• Patient Safety
• Healthcare Quality Improvement

Background:

• Prolonged emergency department (ED) stays necessitate accurate home medication verification, a process known as medication reconciliation.
• The complexity of medication reconciliation can negatively impact patient safety and lead to staff dissatisfaction.

Purpose of the Study:

• To improve the accuracy, timeliness, and staff satisfaction associated with the medication reconciliation process in the emergency department.
• To address identified gaps and challenges within the existing medication reconciliation workflow.

Main Methods:

• A multidisciplinary team implemented an educational intervention and a "Let's chat!" huddle for collaborative medication reconciliation.
• Lean Six Sigma rapid cycle process improvement (define-measure-analyze-improve-control) and SQUIRE 2.0 guidelines were followed.
• Pre- and post-intervention surveys using a 4-point Likert scale assessed staff satisfaction, with real-time evaluations during plan-do-study-act cycles.

Main Results:

• Overall staff satisfaction with medication reconciliation improved post-intervention.
• Significant improvements were observed in the accuracy of medication (20.7%), dose (25.6%), and time last taken (24.5%).
• Staff feedback indicated initial dissatisfaction stemmed from process complexity, unclear roles, time burden, and communication gaps.

Conclusions:

• Implementing a multidisciplinary approach and targeted education can enhance medication reconciliation processes in the ED.
• Engaging the entire care team is critical for improving staff satisfaction and patient safety outcomes.
• Despite a learning curve, the intervention demonstrated a positive impact on key aspects of medication reconciliation.