The medicines' pathway in nursing homes: An updated framework to support effective, safe, and person-centered...

A quality framework for the medicines' pathway in nursing homes was developed during the Come-On study, consisting of eight processes, 27 key activities and 137 best practices. This framework focuses on effective and safe medication processes, but does not include person-centered aspects. Therefore, in this paper, we present an update of the framework, adding person-centered key activities and best practices. We formulated person-centered key activities and best practices based on findings from the RESPECT project. Here, we performed interviews with residents, informal caregivers, and healthcare professionals to investigate their experiences and expectations with regard to resident and informal caregiver involvement in every step of the medicines' pathway. Also, we developed and pilot tested strategies to improve resident and informal caregiver involvement across the medicines' pathway in nursing homes. In total, two key activities and 15 best practices were added to the framework, and four key activities and four best practices were reformulated to strengthen their person-centered character. Adaptions were made in all but three processes (i.e. purchase and ordering, delivery, and medication preparation). The updated framework defines eight processes, 29 key activities and 152 best practices. It provides a base for quality improvement strategies to implement an effective, safe, and person-centered medicines' pathway in nursing homes.