Implementing a change process at one hospital led to significantly fewer errors and an increase in medication reconciliation across units, according to a recent study.
Three teams consisting of consultants and medical staff at 512-bed Forrest General Hospital, Hattiesburg, Miss., were able to reduce transcription errors from 58% to 10% and the number of unreconciled medications from 38% to 10% in two months, according to an article written for Patient Safety and Quality Healthcare. The Marietta, Ga.-based organization publishes research related to healthcare safety issues.
Focusing on the key areas of admission, transfer and discharge, the teams used a seven-step process to create and implement a change process based on stakeholder input. The use of information technology was crucial, especially for the admissions team—the emergency department entered medication information into an electronic system, which allowed the list to rollover to an admissions unit if the patient required a hospital stay, according to the report. In addition, the admissions team created a separate home medication module, which allowed patients to more quickly resume prescriptions after their hospital stay, the team wrote.
"By standardizing the location of the home medication assessment, the admission team was able to ensure that the most up-to-date list of home medications was available throughout the entire hospital stay from admission to discharge," the team stated.
A new transfer reconciliation order form also standardized the process for medical staff handing off patients to other units. Doctors using either a computerized physician order-entry system or handwriting orders were prompted to use the new form, which led to the standard process being used 50% of the time by the end of the study, according to the report.
Similar standardized processes created by the discharge team led to an increase in the use of reconciliation discharge forms to 97% of the time, up from 71.5%, according to the report.
Overall, the initiative raised awareness and support for change among the hospital's executive management team, and collaborating with multidisciplinary teams ensured physician involvement to monitor ongoing improvement efforts as well, the team wrote. "To make sure they remain on track, the team is persisting with efforts to measure results and push for further improvement where warranted," they said.
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