Abstract
BackgroundThe incidence of preventable adverse drug events (ADE) is approximately one medication error per patient per hospital-day. A quality medication reconciliation (MedRec) process is a crucial intervention used to reduce ADE in the hospital and community setting. Amid the coronavirus disease 2019 (COVID-19) pandemic, preventing medication errors is vital to avoid patient readmission, reduce disease complications, and reduce cost and patient burden on the healthcare system.ObjectivesTo develop a standardized MedRec framework that can be implemented in all healthcare settings to reduce patient and staff harm during COVID-19. Also, to create a standardized auditing tool used to assess the quality of the MedRec process and allow for continuous quality improvement.MethodsA multi-site gap analysis (MGA) was performed to collect observational data that were collected from four different healthcare sites (two hospitals, a long-term care facility, and a community pharmacy). MGA consists of collecting data across several sites which answer a standardized questionnaire. A standardized MedRec framework and auditing tool were developed based on the gaps observed in each site and literature reviews.ResultsA standardized MedRec process was not implemented in any of the observed sites. The healthcare sites lacked a designated MedRec team and training related to the MedRec process leading to multiple discrepancies at discharge. Patients were not counselled on changes to home medications, and a discharge report was often not provided upon discharge. Communication mechanisms between community pharmacies and hospital physicians are not available or easily accessible.ConclusionThe proposed structured MedRec framework is vital to reduce medication errors and patient harm amid COVID-19. Moreover, the comprehensive auditing tool developed in this study allows for continuous quality improvement resulting in superior quality care, reduction of workflow inefficiencies, cost savings on hospital readmissions, and overall enhanced healthcare system performance.
Highlights
Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world [1,2,3]
The comprehensive auditing tool developed in this study allows for continuous quality improvement resulting in superior quality care, reduction of workflow inefficiencies, cost savings on hospital readmissions, and overall enhanced healthcare system performance
This questionnaire was only applicable to Winchester District Memorial Hospital (WDMH), FHT in Ontario, Cornwall Long Term Care (LTC) and several differences in the procedures for medication reconciliation (MedRec) were identified
Summary
Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world [1,2,3] Many of these events occur due to poor communication when care is transferred during hospital admissions, between wards, and on discharge to the community or to a residential care facility. In Canada, approximately 50% of hospital medication errors occur during transitions of care, and roughly 30% of these errors have the potential to cause patient harm [4, 5] These errors may occur at various stages, such as when obtaining the patient’s best possible medication history (BPMH), when recording the medications in the medical record, and prescribing medications on admission, transferring to another ward, and discharging. Amid the coronavirus disease 2019 (COVID-19) pandemic, preventing medication errors is vital to avoid patient readmission, reduce disease complications, and reduce cost and patient burden on the healthcare system
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