ISMP Survey on Medication Reconciliation

ISMP is interested in knowing how staff within healthcare facilities are progressing with the Joint Commission’s (JC) National Patient Safety Goal (NPSG) requiring medication reconciliation. Please take a few minutes to complete this survey and submit your responses by May 19, 2006.

About you
1. What is your profession?

Other:

2. What is your staffing level? Other:
3. Are you familiar with the JC NPSG related to medication reconciliation? Yes No
4. Have you attended inservice education regarding your role in medication reconciliation? Yes No
About your facility
5. In what type of facility are you employed?
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
7. For transfers to a different level of care, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
8. For discharges from your care, how long has a medication reconciliation process been in place on your unit/in your department/facility?   
About your process

9. Who is primarily responsible for the following (you may choose more than one category)…

Nurse Pharmacist Physician/ Prescriber Medical Records Other Don’t Know
a. Collecting an initial medication history
b. Assuring the medication history is accurate
c. Reconciling medications between the history and the admission orders
d. Reconciling medications upon transfer of a patient to another level of care
e. Reconciling medications at the time of discharge
f. Sending the patient’s discharge medication list to the patient’s physician/next provider
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list? Yes No Not Sure
12. Your medication reconciliation process is documented on which type of form?
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
14. Please rank the relative importance of success factors and barriers encountered during the implementation of the medication reconciliation program at your facility. Scale: 1=most important, 8=least important (use each number once in the ranking process).
a. SUCCESS FACTORS
Rank
b. BARRIERS
Rank
i. Teamwork among disciplines i. Unreliable patient
ii. Clearly defined protocols ii. Documentation from other sources
iii. Centralized history form/screen iii. Lack of teamwork among disciplines
iv. History collection by pharmacist iv. Extra burden
v. Easy communication with outpatient providers v. Lack of frontline staff input into process
vi. Reasonable expectations for “complete” history vi. Lack of administrative leadership 
vii. Awareness of the role of each contributor vii. Lack of physician leadership
viii. Other: viii. Other:
15. On a scale of 1 to 5, with 1=not valuable and 5=very valuable, please select a number below indicating your perception of the value of the medication reconciliation process to patient safety overall:

Not Valuable 1 2 3 4 5 Very Valuable

16. Other comments:



  

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