Implementing Medication Reconciliation
Veronica Breadner RN
Clinical Nurse Analyst, eHealth Champion,
Halton Healthcare Services
Elaine Hooper RN, PMP
Manager Clinical Information Services
Halton Healthcare Services
This past July, Halton Healthcare Services, Oakville, Ontario, piloted software from Iatrics for Medication Reconciliation. The project was implemented on a busy surgical floor using the Pre-Admission Clinic as the entry point for the patient, and a medical floor that largely services a renal patient population.
Our pre-implementation phase spanned a six-month period, using a multidisciplinary team of nurses, pharmacists, and physicians. We met with various nursing and physician groups throughout the planning phase to introduce the concept and obtain feedback from key stakeholders to ensure that the system worked for all clinicians involved. Our Patient Safety Officer and the Halton network of Safety Champions provided valuable insights into workflow processes and risk assessment.
Iatrics Systems PDI was selected as the software of choice as it provides opportunities to streamline the Medication Reconciliation process, and it ensures that the information is always available in the patient's Electronic Medical Record. Iatrics was intuitive for the nurses as it is similar to software used in electronic documentation at Halton. It lends itself to both paper and electronic environments providing a comfort zone for our paper based orders system and our physicians. The software allows for easy recall of patient's most recent medication history. In addition, pharmacists and physicians were able to see the benefit of the medication list during patient's Ambulatory care visits such as Kidney Function or Cardiac Rehabilitation.
Medication reconciliation is being done in the pilot areas throughout the patient's hospital stay beginning on admission to hospital, when a patient transfers from one unit or service in the hospital and on discharge home or to a community health facility. This provides the patient or other caregiver a clear list of medications to take and what medications have been changed or discontinued. Other patient benefits include a reduction in adverse drug events by reconciling medications on admission, transfer & discharge, improving patient's continuity of care, providing a legible list of current medications without the use of medical jargon, accelerating the admission history process on readmission, and the potential for the patient to gain a greater understanding of their medications.
Our future plans would be to roll out Medication Reconciliation throughout our organization within the next six months. Eventually the Iatrics program will allow for a completely electronic process with the Physician generating e-prescriptions and sending that electronically to community pharmacies.
Veronica Breadner is currently an eChampion at Halton Healthcare Services.