Contact email
jschnipper@partners.org
Overview
This study conducted at 5 sites showed that a multifaceted toolkit of interventions can reduce unintentional medication discrepancies.
Department
Medicine
Collaborators
Jeffrey l schnipper
Amanda Mixon
Jason Stein
Tosha B Wetterneck
Peter J Kaboli
Stephanie Mueller
Stephanie Labonville
Jacquelyn a Minahan
Elisabeth Burdick
Endel John Orav
Jenna Goldstein
Nyryan V Nolido
Sunil Kripalani
Status/Stage of Development
Completed
Measurement
The primary outcome was number of potentially harmful unintentional medication discrepancies per patient; secondary outcome was total discrepancies regardless of potential for harm.
Results
- Potentially harmful discrepancies did not decrease over time.
- Total discrepancies decreased.
- Of the 5 sites, 4 implemented interventions. 3 of the 4 that implemented interventions saw decreases in total discrepancies. The one that did not had also implemented a new EHR and saw an increase in discrepancies.
- The 5th site which did not implement interventions saw an increase in total discrepancies and had also implemented a new EHR.
Additional details
Each site was mentored by a hospitalist/QI expert to facilitate intervention implementation.
Core bundle consisted of:
- best possible medical history
- discharge medication reconciliation
- patient discharge counseling and forwarding medication information to the next providers of care.
Additional components were implemented based on local needs and resources.
The toolkit aimed to
- emphasize basic QI principles
- assign roles and responsibilities to clinical team members, and phased implementation
- have effective HIT design and implementation and social marketing techniques
- frame toolkit goals as standardized functional goal
- allow sites to adapt specific manner of implementation to their local needs and circumstances.
Practice Setting
Academic, community, VA
Sources
Effects of a multifaceted medication reconciliation quality improvement intervention on patient safety: final results of the MARQUIS study. BMJ Qual Saf. 2018 Dec;27(12):954-964. doi: 10.1136/bmjqs-2018-008233. Epub 2018 Aug 20. PubMed PMID: 30126891.
