Transcript What is Medication Continuum of Care and Why Do We Need it in

Use of a Universal Medication
List to Enhance Continuity of
Care in Tennessee
Tennessee Pharmacists Association
Baeteena Black, Executive Director
Patient Continuum of Care Committee
Jeanne Ezell, D.Ph., Chairperson
Partner Organizations:
Tennessee Hospital Association
Tennessee Nurses Association
Tennessee Medical Association
Tennessee Academy of Family Practitioners
Tennessee Dental Association
Tennessee Poison Center
Blue Cross Blue Shield of Tennessee
PROBLEMS
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Medication reconciliation at hospital admission is extremely difficult to
accomplish when patients fail to bring an up-to-date of all their
medications
Past history and medication response are needed to plan patient
treatment
Complete medication profile is needed to screen and prevent
interactions
Communication of medication profile, allergy history, and vaccination
history is needed to prevent discontinuity and fragmentation of care
Confusion often results after hospital discharge when patients are not
clear about medications and doses to be taken
Community pharmacists can not adequately screen patient profiles for
allergies, duplications, drug interactions and other drug-related
problems if they do not have complete lists of patient medications,
reasons for medication use, and allergy histories
TPA Continuum of Care Project Goal
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To improve medication safety in
Tennessee by providing a
universally consistent process for
communicating vital patient
information regarding medications
and allergies across the continuum
of care
What is Continuity of Care in
Medication Management?
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Continuity of care is a longitudinal process
that is coordinated and provided among
practitioners and organizations over time,
consistent with the ongoing needs of the
individual patient.
Medication management is an essential
component of continuity of care.
Why is Medication Continuum of
Care Important?
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Patient harm can result from inaccurate
diagnosis and treatment
Medication Errors can result in
duplications
omissions
interactions
Project Objectives
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Until widespread electronic healthcare
systems are available, all pharmacists will be
urged to provide their patients with a printed
medication profile;
All Tennessee pharmacists will encourage
patients to carry an up-to-date medication
and allergy list with them at all times to be
available at entry and exit from all healthcare
encounters;
Initial Objective
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Develop and promote a common paperbased method of medication information
interchange that any or all Tennesseans can
use in all healthcare encounters
Methods
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Searched for available medication list forms
Conducted a survey of over 300 health care
professionals (pharmacists, nurses, physicians) to
determine most important elements and formats for
a universal medication list form, regardless of
whether electronic or paper
Graded available lists based on important elements
from survey
Adapted Universal Medication List (UML) from
South Carolina (developed by AnMed Health and South
Carolina Hospital Association 2004)
Methods
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Sought collaboration with other healthcare
professional organizations
Posted UML on TPA website for free
download
Translated UML into Spanish
Sent out Press Releases to TPA members
and partner organizations
National Issue
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Enhancing communication of healthcare
information across the continuum of care has
become a nationwide issue
Many states and various organizations are
promoting electronic healthcare data storage
and exchange and electronic prescribing to
improve continuity of care
NTOCC
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National Transitions of Care Coalition
Formed to improve continuity of care
Website has many helpful tools and
information
www.ntocc.org
Pilot Projects
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Blount Memorial Hospital, Maryville – UML adapted
for use with discharge instructions
UT Medical Center, Knoxville – UML included in
ambulatory clinic visit patient check-in process
Community pharmacies are displaying the UML in
waiting areas
UML provided to seniors with Vial of Life at Nashville
Senior Health Expo
UML forms displayed in physician offices
UML used in MTM sessions
Actions Needed
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Healthcare providers must encourage and expect
their patients to carry up-to-date medication
information
Tennessee e-health initiative is promoting
ePrescribing and providing support for sharing
medication information across the continuum of care
Regional Health Information Organizations (RHIOs)
need to be encouraged to include the contents of
the UML in design of patient health information
exchange
Conclusions
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Development and implementation of a
Universal Medication List for use in
Tennessee has been a collaborative project
among healthcare professionals.
The potential impact of this project and
similar projects througout the U.S. on
medication safety should be significant, if
widespread adoption among healthcare
practitioners and the public is fully achieved.
Medications play a key role in
the success or failure of
patient care.