Contact email

jschnipper@partners.org

Overview

This study demonstrates a large reduction in unintentional medication discrepancies through implementation of a refined best practices toolkit with 17 intervention components.

Department

Medicine

Collaborators

Jeffrey Schnipper
Harry Reyes Nieva
Meghan Mallouk
Amanda S. Mixon
Stephanie Rennke
Eugene S.Chu
Stephanie Mueller
G.R. Smith
Mark V. Williams
Tosha B. Wetterneck
Jason Stein
Anuj K. Dalal
Stephanie Labonville
Anirudh Sridharan
E. John Orav
Brian Levin
Catherine Yoon
Marcus Gresham
Jenna Goldstein
Sunil Kripalani

Status/Stage of Development

Ongoing program

Measurement

The primary outcome was unintentional medication discrepancies in admission or discharge orders, measured by comparing them to a gold standard medication history taken by trained pharmacists, supplemented with medical record review.

Results

- The study was done at 18 sites which implemented 1-15 of the intervention components.
- Discrepancy rates decreased from 3 discrepancies: 1 patient to 1 discrepancy: 1 patient.
- Time series analysis showed a 5% decrease per month.
- Patients who received at least 1 patient level intervention had 53% fewer discrepancies than patients who did not receive any (p<0.001).

Major Project Needs

• None

Additional details

- Each site was trained by 1 of 8 hospitalists in the study team through monthly calls and 1-2 site visits
- Each site had a local QI team that assessed local practices, identified improvement opportunities, and implemented toolkit components.

Practice Setting

Academic Hospital

National/Policy Context

The Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in 5 hospitals.

Sources

Jeffrey Schnipper et al. Effects of a Refined Evidence-Based Toolkit on Medication Reconciliation Quality and Safety at Multiple Hospitals: Results of the MARQUIS2 Study [abstract]. In: SGIM Annual Meeting 2019.;May 8-May 11; Washington D.C.