A Comprehensive Medication Management Liaison (CMML) Process Framework for Expanded Interdisciplinary Day-Surgery Teams

Abstract

Implementation science (IS) in the field of surgical care can help with adoption of evidence-based strategies, prevent and manage adverse events, and facilitate high quality medical care. This could be challenging in same day or outpatient surgery settings however. This research letter explores factors in developing a framework to address medication adverse events using CMML with anesthesiology and expanded interdisciplinary outpatient surgical teams. The six-month qualitative study involved interviewing key informants on managing a case example of a perioperative anesthesia adverse event, utilizing Roger’s Diffusion of Innovation Theory as a theoretical framework. Emergent codes and themes pertained to awareness and knowledge of the problem significance, qualifications, empowerment, and financial viability of the proposed liaison role. CMML was found to be valued by study participants with safety and costeffectiveness implications. Still, CMML adoption would require addressing leadership motivators and barriers, multidisciplinary credentialing and engagement to enhance IS research capacity. Key consideration points for implementation are Pre-Admission and Recovery, Internal Medicine consults, Anesthesiologist accessibility, Patient Education, Interdisciplinary Communication. Implementation should build upon existing effective organizational processes, with a framework of Regulatory, Workforce, and Fiscal pillars for IS strategy success.