Welcome to Georgia HEN Hospital Acquired Condition July Affinity Call

July 17, 2013

“Presented to”

Georgia Hospitals

July 17, 2013

Kristine Gleason, MPH, RPh - Clinical Quality Leader, Northwestern Memorial Hospital

Vicky Agramonte, RN, MSN - Project Manager, IPRO

Medication Reconciliation

Objectives

• Explain the benefits MATCH Toolkit for implementing a sustainable medication reconciliation process.

• Explain the time commitment of participation in the MATCH project.

• Promote hospital participation in upcoming regional meetings and follow-up “coaching” calls.

The Georgia Experience Improving Medication Reconciliation

http://www.ahrq.gov/research/findings/case-studies/patient-safety/ps2012g.html

Medication Reconciliation Process

Goal to decrease medication errors and patient harm by:

1. Obtaining, verifying, and documenting patient’s current prescription and over-the-counter medications; including vitamins, supplements, eye drops, creams, ointments, and herbals

2. Comparing patient’s pre-admission/home medication list to ordered medicines and treatment plans to identify unintended discrepancies

3. Discussing unintended discrepancies (e.g., those not explained by the patient’s clinical condition or formulary status) with the physician for resolution

4. Providing and communicating an updated medication list to patients and to the next provider of service at discharge

Adapted from The Joint Commission National Patient Safety Goal 03.06.01

Achieving Synergies:Linking Medication Reconciliation

with Other Current Initiatives

“Bundling” Medication Reconciliationwith Current Initiatives

Med History, Reconcile

Order, Transcribe,

Clarify

Procure, DispenseDeliver

Administer Monitor Educate, Discharge

Phases of Medication Management

Identifying Opportunities to “Bundle” Medication-related Initiatives

Care Transitions

• Reducing medication-related readmissions•Process of Care (Core) Measures•Meaningful Use of EHRs involving medications•Effective communication/handoff practices with next provider of service

• Avoiding preventable ADEs•TJC Med Mgmt Standards and NPSGs (e.g., high alert meds, anticoagulants)• Patient Experience (HCAHPS)• Follow-up Phone Calls Post-Discharge

MATCH Toolkit: Step-by-Step Guide to MATCH Toolkit: Step-by-Step Guide to Improving Medication ReconciliationImproving Medication Reconciliation

MATCH Toolkit, with customizable, actionable

information, is available at: http://www.ahrq.gov/qual/match/

match.pdf

Guiding Principles• Clearly define roles and responsibilities.

• Standardize, simplify, and eliminate unnecessary redundancies.

• Make the right thing to do the easiest thing to do.

• Develop effective forcing functions, prompts, and reminders during the appropriate time within workflow.

• Educate workforce, and patients, families, and caregivers.

• Ensure process design meets all pertinent local laws or regulatory requirements.

• Commitment to the “One Source Of Truth” medication management system.

Assessing the Quality of Medication Reconciliation

• Evaluation of the medication reconciliation process post-implementation to determine:

– Frequency and causes of medication reconciliation failures

– Type of discrepancies involved

– Potential patient harm averted

– Patient and/or medication-related risk factors frequently responsible for inaccurate medication reconciliation

Supported by grant number 5 U18 HS015886 from the Agency for Healthcare Research and Quality (AHRQ).Publication: Gleason KM, McDaniel MR, Feinglass J, et al. J Gen Intern Med. 2010 May;25(5):441-7.

Goal: To eliminate avoidable adverse drug events and associated patient harm due to medication discrepancies.

MATCH “lite” Collaborative Timeline

• July 17, 2013 HAC Call to introduce collaborative

• July 31, 2013 Introduction to the MATCH toolkit and Collaborative Pre-work

• August 20, 2012 Regional Meeting – Savannah

• August 27, 2013 Regional Meeting – Atlanta

• September/October Coaching Calls – Date/Time TBD

Vicky Agramonte, RN, MSNProject Manager

Healthcare Quality Improvement Program Island Peer Review Organization, Inc. (IPRO)

 Albany, NY 12211-2370(518) 426-3300 X115vagramonte@ipro.org

Kristine Gleason, MPH, RPhClinical Quality Leader

Northwestern Memorial Hospital Chicago IL 60611

312.926.9172kmgleaso@nmh.org

Questions and Discussion

THANK YOU!THANK YOU!

If you want to learn more about IPRO, please visit our website at: http://www.ipro.org.If you want to learn more about Northwestern Memorial Hospital, please visit our website at http://www.nmh.org.