Medication Reconciliation is a Physician Issue

1. Medication Reconciliation is a Physician Issue

2. What is Medication Reconciliation? • In acute care… • Creating the list of medications your patient is on at home. • Accounting for each home medication when the patient enters the episode of care. • Communicating the discharge medication list and why there are changes from the home medication list.

3. Medico-legal Precedents *2013 CMPA educational publication

4. Evidence in the Literature

5. Why is this not being done on SCM or Netcare? • Current SCM cannot create a functional home medication list…. yet. • The pharmacy uploads to Netcare are NOT proper medication lists (and never will be). They reflect medications dispensed, not medications taken – this can only obtained though history. • Med Rec can get on Netcare using your discharge summary.

6. BPMH ADMISSION DISCHARGE TRANSITIONS OF CARE (transfer) Complete “Medication Reconciliation at Transitions of Care” report from SCM TRANSITION OF CARE (transfer) Complete “Medication Reconciliation at Transitions of Care” report from SCM

7. MedRec Transitions of Care Report in SCM

8. Eg: transfer from surg to hospitalist Transferring doctor to compare these meds with the home med list and document reasons for any changes. Transferring doctor to handwrite any medications that appear on the BPMH that do not appear on this list and document reasons for omission.

9. MedRec Transitions of Care Report in SCM A Medication Reconciliation at Transitions of Care report has been developed in the current 5.0 version of SCM This portion of the report will capture the patient’s current medication list in SCM

10. Discharge – 3 Ways to do a Summary • SCM discharge summary – compare current meds to the home med list (BPMH), and type the reasons for changes into the white box below the med list. • Dictated discharge summary – same as above, but after dictating the meds for discharge, dictate the reasons for changes from the home med list. • Handwritten – Do Med Rec on the Form. In your discharge order, request the form be photocopied and faxed to the family doctor.

12. Discharge

13. Roll out of MedRec in Acute CarePLC Nov. 26, 2013FMC Jan 20, 2014ACH Dec 9, 2013RGH Nov/Dec, 2013SHC Sept, 2013

14. Medication Reconciliation • Outpatient clinics • Implementation is required by Dec, 2015 • In development….

15. What about patient or community pharmacist involvement? Patients: • A resource developed by the HQCA is available in print, and on the AHS website. Pharmacists: • There is a fee code for doing a patient interview and creating a medication list. Currently it requires a phone call to the pharmacist to obtain this list, if it is done.

16. Calgary Zone Project Team • Lynn Whitten, Project Manager: 403-909-9894 • Dr. Echo Enns, Physician Lead: 403-616-0844 • Nancy Hoeght, Project Coordinator: 403-619-5975 • Mandy McCabe, Project Coordinator: 403-605-7190 • Kathy Lee, Pharmacy Consultant: 403-943-3877 • Alim Amershi, Project Coordinator (data): 403-615-4739 • Main Number - Administrative Assistant: 403 943-3532 In site Web Pages MedRec - http://insite.albertahealthservices.ca/5713.asp Elearning modules - http://insite.albertahealthservices.ca/8740.asp Accreditation - http://insite.albertahealthservices.ca/4086.asp

17. Discharge

18. Why MedRec? Identified by AHS as a major patient safety initiative An Accreditation Canada Required Organizational Practice Identified by the World Health Organization as one of the top 5 priorities , “the High Fives Project” Med Rec will be integrated into all AHS clinical service delivery areas by Dec 2015

19. The Solution on Admission to Acute Care: Med Rec is where we take this…

20. and before you know it, this!

21. and turn it into this… (for now…)