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A TARGETED STRATEGY AND TRAINING PROGRAM TO IMPROVE THE MEDICATION RECONCILIATION PROCESS

European Statement

Clinical Pharmacy Services

Why was it done?

Medication reconciliation at admission was implemented in our hospital in 2011 and since then we could hardly meet the expectations of clinicians (completion of a Best Possible Medication History (BPMH) for 70% of patients in less than 24 hours). We also observed that the high patient volume decreased the quality of our BPMH completion process.

What was done?

We developed a strategy and an organisational thinking to remove human and technology barriers in performing medication reconciliation (MR). We designed a program to improve the overall quality of MR and increase the added value of MR for clinicians, nurses and pharmacists.

How was it done?

Our approach included four steps:
(1) “customer approach”; by conducting semi-structured interviews with students, clinicians and nurses to get their feedback, needs, expectations about medication reconciliation,
(2) literature review with Pubmed® and Embase®and benchmarking of other similar practices in France and Canada
(3) set a task force including pharmacists and students to define a strategy and metrics
(4) design solutions and assess them.

What has been achieved?

First, we defined and chose to target “High risk” admission inpatients only. Second, a training program based on two e-learning modules was implemented to develop skills of pharmacy students and residents. This program explores the “why” of conducting MR based on real life examples. It also defines the “what” (what is MR) and the “how” (i.e the different steps to run a MR and how to appropriately interact with the patient).

What next?

At each student rotation, the efficacy of the training program will be evaluated by comparing the concordance of BPMHs performed separately by a student and a pharmacist. A survey will be conducted to evaluate the level of learners’ satisfaction.

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