Auditing medication reconciliation
BIDMC has a major focus on process improvement and lean approaches to workflow.
When we declare a goal we develop metrics to track our processes and remeasure our performance to ensure our changes have a lasting effect.
I was recently asked about our adherence to medication reconciliation, a Joint Commission requirement and a pay for performance goal for us.
We have 3 major medication reconciliation workflows - Emergency Department, Inpatient and Outpatient - which ensure we document a complete medication list at every transition and communicate that list to the next provider, ensuring continuity of care.
Our last audit was completed on November 19, 2008.
* A total of 1326 records across the various areas were reviewed
* We found 95% compliance with Communication of Updated List of Medications to Next Provider of Care.
Each time we do an inpatient review, we select a date and then review discharges from the prior two days. In the last round, the date selected was 11/19, and we reviewed 161 discharges from 11/17 and 11/18. There were 263 discharges on those days, so the % reviewed was 61%.
Our full results are below:
|Service Line||Visits Reviewed||Medications Added||Sent to Next Provider||%|
|Same Day Surg||55||38||35||92%|
We will continue this quarterly monitoring into 2009 and the dates to save include:
Wednesday, February 11, 2009
Wednesday, May 20, 2009
Wednesday, August 19, 2009
Wednesday, November 18, 2009