cmh medication reconciliation journey 2011
DESCRIPTION
TRANSCRIPT
Designing the Process
• 2008 Strategic Plan identified Med Rec as a critical process requiring an action plan.
• MIB (make it better) initiated• Team established by action plan owner, to include clinical
leaders from all disciplines– Acute Care– Home Care/Hospice– Clinics– Long Term Care– Pharmacy– Physicians
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• Each discipline/business unit identified a leader and a team of peers – Clinical staff– Information Specialists or Technicians– Quality/Performance Improvement staff
• A process flow diagram was drawn for each discipline– Informal FMEA (failure modes effects analysis) was
applied to each process, to identify weak steps or steps lending to failure
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• Basic med. rec. education was developed and provided to all clinical staff.
• The first step included buy in by nurses and physicians to stop using and accepting: “resume all meds”.
• IS focused on designing improvements in the listing of medications, and methods for electronic med rec for transfers within the system.
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Roll Out
• Initial process rolled out in Emergency Dept.• To Acute care and physicians
o An admission/discharge nurse was hired, med.rec. was part of this role’s responsibility
• Clinics with each visit• Home Care – learning to work with a new
software program• LTC is in initial process of rolling out for
admission from home 5
• Summer of 2010 joined the national collaboration with Primaris– Outlined processes again- new issues identified– Staff had designed “work arounds”– Staff focused on admission and discharge, ignoring
med rec at transfer
New focus on education of nurses, physicians, community:
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Education in process or for consideration: New employee orientation Annual one/one competency for nurses Interactive Healthstream courses for
nurses One/one education with physicians
Monthly news letters with bits of med rec education
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Community Education:Website paragraphsPrintable med list on websiteArticles in CMH quarterly magazineBrief articles in newspaper or on radioAccess to med list from electronic portals
possibly from Patient Friendly registration card
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Lessons Learned
• Staff from all business units must know where to find the “source of truth”
• We can measure completion of med rec but it is very difficult to find the resources to track accuracy
• Staff becomes dependent on the system to guide the process
• Biggest Lesson Learned: We have a process now but if one person does not do their part completely the entire process is impacted and it is hard to identify errors.
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For More Information or Clarification
• Aileen Kelley RN,BC CMH Quality Coordinator– [email protected]
• Michelle Cahow CMH IS Specialist– [email protected]
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