ISMP Survey on Medication Reconciliation

Hospital Total: 1290
About you
1. What is your profession?
Nurse 72%
Other 3%
Pharmacist 24%
Physician/prescriber 1%
2. What is your staffing level?
Administrator 11%
Manager 35%
Other 17%
Staff 36%
3. Are you familiar with the JC NPSG related to medication reconciliation? 93% - Yes 7% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 77% - Yes 23% - No
About your facility
5. In what type of facility are you employed?
Hospital 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 6%
1-3 months 20%
3-6 months 31%
6-12 months 19%
Don’t know 8%
More than a year 16%
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? 
0 months 13%
1-3 months 18%
3-6 months 25%
6-12 months 17%
Don’t know 10%
More than a year 18%
8. For discharges from your care, how long has a medication reconciliation process been in place on your unit/in your department/facility?   
0 months 12%
1-3 months 20%
3-6 months 25%
6-12 months 16%
Don’t know 12%
More than a year 15%
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 91% 5% 30% 1% 2% 0%
b. Assuring the medication history is accurate 75% 22% 45% 1% 2% 3%
c. Reconciling medications between the history and the admission orders 61% 26% 51% 0% 1% 4%
d. Reconciling medications upon transfer of a patient to another level of care 65% 22% 53% 0% 1% 4%
e. Reconciling medications at the time of discharge 66% 12% 59% 0% 1% 6%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 48% 3% 18% 9% 10% 25%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 10%
24 46%
36 1%
48 2%
Not Sure 31%
Other 10%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 53%
Not Sure 34%
Yes 13%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 25%
Computer charting system 13%
Not documented 3%
Not sure 5%
Paper chart 55%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 33%
Never 43%
Not Sure 9%
Sometimes 15%
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
1 56%
2 16%
3 10%
4 6%
5 5%
6 3%
7 2%
8 3%
i. Unreliable patient
1 41%
2 16%
3 13%
4 10%
5 7%
6 5%
7 5%
8 4%
ii. Clearly defined protocols
1 39%
2 24%
3 13%
4 10%
5 6%
6 3%
7 3%
8 2%
ii. Documentation from other sources
1 17%
2 19%
3 17%
4 15%
5 12%
6 10%
7 8%
8 3%
iii. Centralized history form/screen
1 32%
2 20%
3 16%
4 12%
5 7%
6 5%
7 4%
8 3%
iii. Lack of teamwork among disciplines
1 30%
2 16%
3 15%
4 13%
5 10%
6 6%
7 6%
8 4%
iv. History collection by pharmacist
1 10%
2 7%
3 9%
4 11%
5 11%
6 11%
7 23%
8 18%
iv. Extra burden
1 22%
2 18%
3 14%
4 16%
5 10%
6 8%
7 9%
8 5%
v. Easy communication with outpatient providers
1 13%
2 12%
3 13%
4 13%
5 14%
6 18%
7 13%
8 4%
v. Lack of frontline staff input into process
1 18%
2 12%
3 15%
4 13%
5 13%
6 14%
7 9%
8 5%
vi. Reasonable expectations for “complete” history
1 23%
2 18%
3 15%
4 14%
5 13%
6 10%
7 5%
8 2%
vi. Lack of administrative leadership 
1 15%
2 13%
3 11%
4 10%
5 12%
6 13%
7 18%
8 9%
vii. Awareness of the role of each contributor
1 23%
2 17%
3 15%
4 13%
5 11%
6 9%
7 9%
8 3%
vii. Lack of physician leadership
1 32%
2 18%
3 11%
4 11%
5 8%
6 9%
7 8%
8 5%
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:

1 3%

2 6%

3 10%

4 21%
5 61%

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