Medication reconciliation is a major patient safety concern nationally and is linked to CMS measures. In 2006 an audit of the discharge medication list given to patients and the hospital summary sent to The primary was conducted. At That time a handwritten carbon copy form was used lo generate both the dictated and handwritten lisls. Fewer lhan 15% of the lisls were reconciled. An analysis of CMS measures specific to CHF showed that 90% of fallouts were secondary to reconciliation errors. The hospital, working with the IM residents, started an FMEA project focusing on getting an accurate summary lo the primary. One barrier identified was the carton copies were difficult to read, leading to both transcription errors by nursing and dictation errors by providers. In November 2007 a pilot sludy was initiated looking at the impact of dictating 1 list lhal would be given to both the patient and the primary.
The purpose of the study was to improve patient safety by reducing medication reconciliation errors by providing both the patient and primary with the same dictated list.
Transcription established a STAT line for discharge medication lisls. To keep from overwhelming the transcription service and ensure quick turnaround times, only the medication list could be done on this line the remaining parts of the discharge summary was done separately. The residents were instructed on how to dictate the reconciled list in palient‐friendly language and to include the primary provider Once the list was transcribed, it was faxed lo the floor and entered in the EMR. The resident reviewed the list and if correct, signed it and gave it lo the nurse. If there were errors, they corrected them in the EMR and gave the new list to Ihe nurse. The nurse would then review the medications list with the patient. Because the list was already in palient‐friendly language, this eliminated the need transcribe the list and reduced the chance for errors. Subsequenl audits showed the average time it took for the dictation to reach the floor was 30 minutes, resident compliance with all the required elements of the list (patient‐friendly language, provider information) exceeded 95%, and more than 80% of primaries were receiving the lisL Fallouts for CHF declined significantly, and CMS scores moved from Ihe third to the first quartile. Because the pilol showed such initial success, it was implemented house‐wide. This system has now been in place for 2 years, and CMS CHF fallouts because of medication reconciliation have remained low. Since implementation only 1 fallout has been attributed to a resident.
By using a single reconciled medication listed dictated in palient‐friendly language, significant improvements can be seen both in medication reconciliation and CMS measures, which has a positive impact on patient safety.
J. Jordan, none; M. Gennis, none; A. Khogali, none; T. Keck, none.
To cite this abstract:Jordan J, Gennis M, Khogali A, Keck T. Improving Patient Safety and CMS Performance through Medication Reconciliation 170. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 170. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/improving-patient-safety-and-cms-performance-through-medication-reconciliation-170/. Accessed March 29, 2020.