DRIVING QUALITY HEALTH SERVICES ACCREDITATION CANADA AGRÉMENT CANADA Accredited by ISQua...
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DRIVING QUALITY HEALTH SERVICES ACCREDITATION CANADA AGRÉMENT CANADA Accredited by ISQua Accreditation Canada & ISMP Canada Accreditation Canada & ISMP Canada ISMP Community of Practice ISMP Community of Practice Medication Reconciliation Medication Reconciliation October 15, 2008 October 15, 2008
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Transcript of DRIVING QUALITY HEALTH SERVICES ACCREDITATION CANADA AGRÉMENT CANADA Accredited by ISQua...
DRIVING QUALITY HEALTH SERVICES
ACCREDITATION CANADAAGRÉMENT CANADA
Accredited by ISQua
Accreditation Canada & ISMP CanadaAccreditation Canada & ISMP CanadaISMP Community of Practice ISMP Community of Practice
Medication ReconciliationMedication Reconciliation
October 15, 2008October 15, 2008
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OutlineOutline
Background
Answers to common questions
Additional questions
Background
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Required Organization Practices Required Organization Practices (ROPs)(ROPs)
ROPs are Evidence-based expectations to enhance
patient/client safety and minimize risk Requirements for organizations in accreditation Relevant to organizations across the continuum of
care
Incorporated into the accreditation program in 2006, and now integrated within Qmentum standards
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Required Organization Practices Required Organization Practices (ROPs) (ROPs) cont’dcont’d
ROPs were developed in collaboration with Key stakeholders
Institute for Safe Medication Practices Canada Canadian Patient Safety Institute Canadian Medical Protective Agency Canadian Institute for Health Information Healthcare Insurance Reciprocal of Canada
Content experts on Accreditation Canada Patient Safety Advisory Committee (PSAC)
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Patient Safety Required Patient Safety Required Organization Practices (ROPS)Organization Practices (ROPS)
ROPs organized in several important patient safety areas:ROPs organized in several important patient safety areas:
1.1. CultureCulture
2.2. CommunicationCommunication
3.3. Medication UseMedication Use
4.4. WorklifeWorklife
5.5. Infection controlInfection control
6.6. Falls preventionFalls prevention
7.7. Risk assessment Risk assessment More information about all ROPs is available at More information about all ROPs is available at
http://www.accreditation-canada.ca/default.aspx?page=355&cat=30http://www.accreditation-canada.ca/default.aspx?page=355&cat=30
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Patient Safety Required Patient Safety Required Organization Practices (ROPS)Organization Practices (ROPS)
Medication reconciliation represents 2 Communication ROPsMedication reconciliation represents 2 Communication ROPsCommunication : Improve the effectiveness and coordination of communication
among care/service providers and with the recipients of care/service across the continuum.
Required Organizational Practices:
1. Inform and educate patients/clients about their role in patient safety (written and verbal communication)2. Employ effective mechanisms for transfer of information at interface points3. Implement verification processes and other checking systems for high risk care/service activities4. Reconcile the patient’s/client’s medications upon admission to the organization, and with the
involvement of the patient/client.
5. Reconcile medications with the patient/client at referral or transfer, and communicate the patient’s/client’s medications to the next provider of service
More information available at http://www.accreditation-canada.ca/default.aspx?page=355&cat=30
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What is Medication What is Medication Reconciliation?Reconciliation?
Medication reconciliation is the collection and communication of accurate client/patient medication information
Medication reconciliation is important for continuity of patient/client medications to Reduces likelihood of medication errors Potentially uncover medication errors that may
harm patients/clients
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Medication Reconciliation for Medication Reconciliation for 2008 and 20092008 and 2009
To promote consistent practice and evaluation, Accreditation Canada has established the following expectations for medication reconciliation for organizations being surveyed in 2008 and 2009 Medication reconciliation is considered implemented, when the
organization has: a formal process for medication reconciliation at admission in at
least one unit/ service area/ site, and a formal process for medication reconciliation at transfer or
referral in at least one unit/ service area/ site, and a documented plan that includes timelines for implementation of
medication reconciliation across all units/ services areas/ sites.
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Medication Reconciliation Medication Reconciliation beyond 2009beyond 2009
Accreditation Canada is reviewing information from the field and results from accreditation surveys to determine medication reconciliation expectations for organizations being surveyed in 2010
Accreditation Canada anticipates organizations will remain committed to patient safety by continuing to implement medication reconciliation
Common Questions
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Medication Reconciliation Medication Reconciliation IndicatorIndicator
Do we only have to collect information on the number of patients that receive medication reconciliation on admission?
Answer:
Yes, that is the only indicator for medication reconciliation at this time
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Medication Reconciliation Medication Reconciliation Indicator Indicator cont’dcont’d
How often do we collect the indicator?
Answer:
The data is to be collected on a continuous basis
The requirement for reporting is annually but the data are entered in fields that reflect quarters
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Medication Reconciliation Medication Reconciliation Indicator Indicator cont’dcont’d
What is the numerator and denominator?
Answer:
Denominator: Total number of patients admitted to the unit of service at the organization for the measurement period
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Medication Reconciliation Medication Reconciliation Indicator Indicator cont’dcont’d
Numerator: number of patients who receive formal medication reconciliation
If criteria are used to identify who receives medication reconciliation, the criteria need to be identified e.g. patients on 4 or more pre-admit
medications, patients > 75 years old, etc.
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Medication Reconciliation Medication Reconciliation Indicator Indicator cont’dcont’d
An explanation should be provided for why criteria are being used to select individuals for medication reconciliation
Organizations enter the information in the comment box in portal under the medication reconciliation indicator
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Medication Reconciliation at Medication Reconciliation at Transfer Transfer
Does Transfer include discharge?
Answer:
Yes, discharge is meant to be included in “transfer to another setting, service, service provider or level of care within or outside the organization”
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Medication Reconciliation in Medication Reconciliation in EmergencyEmergency
Do all triaged patients in ED need to receive medication reconciliation?
Answer:
Yes, currently this is how the standard is written
Based on feedback from the field this requirement is being reviewed
Results from the review will be communicated to all organizations
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Medication Reconciliation in Medication Reconciliation in Ambulatory CareAmbulatory Care
Ambulatory care and clinics do not always include admission or care related to medications; is it necessary to do medication reconciliation?
Answer:
Based on feedback from the field the details and requirements of the ROP for outpatient settings is currently being reviewed
Results from the review will be communicated to organizations
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Medication Reconciliation in Medication Reconciliation in Ambulatory Care Ambulatory Care cont’dcont’d
Still important for safety of outpatient services to reconcile medications (such as outpatient surgery, dialysis facilities, outpatient oncology clinics, and family practice areas)
The process for reconciling medications in outpatient settings is different than the process for inpatient transitions
A medication list is collected to know what medications a patient is taking or receiving prior to the outpatient visit in order to provide quality care
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Medication Reconciliation in Medication Reconciliation in Ambulatory Care Ambulatory Care cont’dcont’d
At the end of the outpatient visit, two things should be verified: Based on what occurred in the visit, is any medication
that the patient was taking or receiving prior to the visit being discontinued, altered, or held pending consultation with the prescriber?
Have any new prescriptions been added?
Based on the answers to the these questions reconciliation and follow up can occur
More information is available from ISMP
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Medication Reconciliation in Medication Reconciliation in Home careHome care
Homecare services do not always involve medications; is it necessary to do medication reconciliation?
Answer:
It is important for homecare services to do medication reconciliation when they are involved in a medication management with clients
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Pharmacist Role in Medication Pharmacist Role in Medication Reconciliation Reconciliation
What is the role of a pharmacist in medication reconciliation?
Answer:
Pharmacists play a key role in assisting with medication reconciliation
Accreditation Canada specifies in the test for compliance that medication reconciliation is a shared responsibility involving the pharmacist
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Medication Reconciliation for Medication Reconciliation for Respiratory TherapyRespiratory Therapy
As a RT company we only deliver oxygen to clients; do we need to do medication reconciliation?
Answer:
Yes, medication reconciliation remains an important part of safe services
Accreditation Canada requires RT organizations review medications for possible interactions or contraindications with oxygen
More details are available on the Accreditation Canada website
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Service area / site / unit Service area / site / unit
What is the difference between these terms?
Answer:
All three terms were used to reflect how different organizations are structured and where medication reconciliation may take place
Common meanings are: Site is facility you work for, e.g. hospital, long term care home ,
home care agency Service could be the specialty where you work, e.g. medicine ,
surgery Unit is the specific unit where you work, e.g. Medicine 4D
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Best Possible Medication Best Possible Medication History History
For the comprehensive list of medications can it be the BPMH – for Safer Healthcare Now?
Answer:
Yes, it is one kind of process that can be used
Part 3
Additional Questions
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Accreditation Canada Accreditation Specialist
Accreditation Canada Technical Support
Accreditation Canada’s Website: www.accreditation-canada.ca
Organization Portal
Accreditation Canada Resources Accreditation Canada Resources
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