Transcript Collaborative Development and Implementation of a Universal

Collaborative
Development and
Implementation of a
Universal Medication
List
Jeanne R. Ezell, Blount Memorial
Hospital, Maryville, Tennessee;
Baeteena M. Black, Tennessee
Pharmacists Association, Nashville,
Tennessee
PROBLEMS
• Medication reconciliation at hospital admission is
extremely difficult to accomplish when patients
fail to bring an up-to-date list 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,omissions and
duplications
• Communication of medication profile, allergy
history, and vaccination history is needed to
prevent discontinuity and fragmentation of care
PURPOSE
TPA Continuum of Care Project
Goal
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
Initial Objective
• Develop and promote a common paperbased method of medication information
interchange that Tennesseans can use in
all healthcare encounters
Additional Project Objectives
• Until electronic systems are widely
available to share personal health
information, all Tennessee pharmacists will
provide their patients with a medication list
• All Tennessee pharmacists will encourage
patients to carry an up-to-date medication
list with them at all times to be available at
entry and exit from all healthcare
encounters
Methods
• Searched for available medication list forms
• Conducted a survey of health care professionals
(pharmacists, physicians, nurses) 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)
• Sought collaboration with other healthcare
professional organizations in Tennessee
Methods
• Posted UML on TPA website for free download
(887 hits Feb15-May15)
• Translated UML into Spanish
• Sent out UML Press Releases to TPA members
and partner organizations
• UML presented at state association-sponsored
meetings, published in newsletters, and included
in meeting packets
• Surveyed TPA members on usefulness of UML
• Community hospital surveyed patients on
usefulness of discharge UML
• Community hospital assessed accuracy and
completeness of discharge UML
Pilot Projects
• 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
Results
• Survey of TPA members (110 respondents)
– 20% had implemented UML in their practice
– Most common use was distributing UML to
patients
– Most common barrier to use was lack of
pharmacist time to assist patients in filling out
the UML form
– Frequent barrier was difficulty incorporating
the UML elements into the pharmacy’s
electronic system
Results
• Survey of BMH patients’ discharge UML
- 70% said medication list was legible
- 60% were carrying UML at all times
6%
3%
30%
0%
21%
61%
Do you keep the UML with you at all times and
take it to your physician and pharmacy?
9%
70%
Could you read all your medications?
Yes
No
N/A
Don't Know
Yes
No
N/A
Don't Know
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Bo
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Number of Evaluations
Results
Discharge UML Audit
Universal Medication List Evaluation
25
20
15
10
Yes
No
5
0
Recommendations
• Healthcare providers must encourage and
expect their patients to carry up-to-date
medication information
• Tennessee e-health initiative is anticipated to
provide 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
• Development and implementation of a
Universal Medication List for use in
Tennessee has been a collaborative
project among health care professionals.
• The potential impact of this project on
medication safety should be significant if
widespread adoption of the UML among
healthcare practitioners and the public is
fully achieved.
Medications play a key role in
the success or failure of
patient care.
Tennessee Pharmacists Association
Baeteena Black, Executive Director
Continuum of Care Committee
Jeanne Ezell, 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
Disclosure
Authors of this presentation have the
following to disclose concerning possible
financial or personal relationships with
commercial entities that may have a direct
or indirect interest in the subject matter of
this presentation:
Jeanne Ezell: Nothing to disclose
Baeteena Black: Nothing to disclose