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. 2021 Jan 19;14(1):10.
doi: 10.1186/s40545-021-00296-w.

Avoiding a Med-Wreck: a structured medication reconciliation framework and standardized auditing tool utilized to optimize patient safety and reallocate hospital resources

Ali Elbeddini  1 , Sarah Almasalkhi  2 , Thulasika Prabaharan  2 , Cindy Tran  2 , Mohamed Gazarin  3 , Ahmed Elshahawi  4
Affiliations

Avoiding a Med-Wreck: a structured medication reconciliation framework and standardized auditing tool utilized to optimize patient safety and reallocate hospital resources

Ali Elbeddini et al. J Pharm Policy Pract. .

Abstract

Background: The incidence of preventable adverse drug events (ADE) is approximately one medication error per patient per hospital-day. A quality medication reconciliation (MedRec) process is a crucial intervention used to reduce ADE in the hospital and community setting. Amid the coronavirus disease 2019 (COVID-19) pandemic, preventing medication errors is vital to avoid patient readmission, reduce disease complications, and reduce cost and patient burden on the healthcare system.

Objectives: To develop a standardized MedRec framework that can be implemented in all healthcare settings to reduce patient and staff harm during COVID-19. Also, to create a standardized auditing tool used to assess the quality of the MedRec process and allow for continuous quality improvement.

Methods: A multi-site gap analysis (MGA) was performed to collect observational data that were collected from four different healthcare sites (two hospitals, a long-term care facility, and a community pharmacy). MGA consists of collecting data across several sites which answer a standardized questionnaire. A standardized MedRec framework and auditing tool were developed based on the gaps observed in each site and literature reviews.

Results: A standardized MedRec process was not implemented in any of the observed sites. The healthcare sites lacked a designated MedRec team and training related to the MedRec process leading to multiple discrepancies at discharge. Patients were not counselled on changes to home medications, and a discharge report was often not provided upon discharge. Communication mechanisms between community pharmacies and hospital physicians are not available or easily accessible.

Conclusion: The proposed structured MedRec framework is vital to reduce medication errors and patient harm amid COVID-19. Moreover, the comprehensive auditing tool developed in this study allows for continuous quality improvement resulting in superior quality care, reduction of workflow inefficiencies, cost savings on hospital readmissions, and overall enhanced healthcare system performance.

Keywords: Auditing tool; COVID-19; Cost-effective analysis; Medication errors; Medication reconciliation.

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Conflict of interest statement

No known competing interest to declare.

Figures

Fig. 1
Fig. 1
Standardized MedRec components. Five key components were identified for the MedRec process: (1) pharmacy-led MedRec team, (2) patient education and involvement, (3) complete and accurate BPMH, (4) admission/discharge reconciliation, and (5) interprofessional communication
Fig. 2
Fig. 2
MedRec team requirements
None
See this image and copyright information in PMC

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