Transcript MPAMedscheck - Communities of Practice

Medication Reconciliation
and MedsCheck Initiative
with Community Pharmacists
Alice Hogg, RPh
Shellyna Moledina, RPh
Patricia Brown, RPh
May 6, 2008
© Institute for Safe Medication Practices Canada 2007®
Medication Reconciliation
What Is It?
• A process where medications are
compared at interfaces of care
• Discrepancies are identified and
reconciled with the physician
• Intervention minimizes patient harm
from unintended discrepancies
© Institute for Safe Medication Practices Canada 2007®
Best Possible Medication History
BPMH is a list of what the patient is actually taking
(not necessarily just what was prescribed)
• Gathered by using more than 1 source of information
(e.g. MedsCheck, patient interview, medication vials,
Drug Profile Viewer, medication profile, community
pharmacist, family physician)
• identify and resolve discrepancies between what
was ordered and what the patient is actually
taking
• contact the physician to resolve discrepancies
© Institute for Safe Medication Practices Canada 2007®
Why is the BPMH useful?
• Helps to ensure home medications are
continued in hospital if appropriate
• Helps to resolves discrepancies between
what was ordered and what the patient was
actually taking prior to admission
• Ensures continuity of care
© Institute for Safe Medication Practices Canada 2007®
2008 ISMP Canada
MedRec/MedsCheck Hospital Project
• 10 hospital sites
• Pre-admission surgical clinic - elective patients
• Asking patients for a MedsCheck to be done
prior to admission to the hospital
• RN gathers Best Possible Medication History at
preadmission clinic
• Using MedsCheck as the primary source of
information
• Measure the value and impact of the
MedsCheck program to MedRec in hospital
© Institute for Safe Medication Practices Canada 2007®
MedsCheck
Ministry of Health and Long-Term Care
© Institute for Safe Medication Practices Canada 2007®
Community Pharmacist’s Role
• Accommodate patient’s requests for
MedsCheck or Follow-Up prior to their preadmission clinic appointment. (1-2 weeks)
• Record all the medications the patient is
actually taking even if it differs from the
prescribed instructions.
• The profile should include all current
prescription and over-the-counter
medications.
© Institute for Safe Medication Practices Canada 2007®
What is the effect on Patient Care?
• Develops and strengthens the relationship
between patients and their community pharmacist.
• Improves seamless care between the community
and hospital to ensure patients receive medications
correctly and appropriately between transfers of
care.
• Prevents medication errors and improves the
efficiency and accuracy of the medication ordering
process in hospital.
• Impacts the entire continuum of care
© Institute for Safe Medication Practices Canada 2007®
Linking MedsCheck to
Medication Reconciliation
Coordinating MedsCheck and medication
reconciliation in Ontario will contribute to the
seamless transfer of accurate information and
contribute to the improvement of patient care
and safety.
© Institute for Safe Medication Practices Canada 2007®