ISMP Survey on Medication Reconciliation

Surgery center Total: 38
About you
1. What is your profession?
Nurse 53%
Other 8%
Pharmacist 21%
Physician/prescriber 18%
2. What is your staffing level?
Administrator 11%
Manager 37%
Other 34%
Staff 18%
3. Are you familiar with the JC NPSG related to medication reconciliation? 94% - Yes 6% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 61% - Yes 39% - No
About your facility
5. In what type of facility are you employed?
Surgery center 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 16%
1-3 months 8%
3-6 months 16%
6-12 months 32%
Don’t know 3%
More than a year 26%
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 11%
1-3 months 11%
3-6 months 21%
6-12 months 11%
Don’t know 8%
More than a year 39%
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 13%
1-3 months 11%
3-6 months 8%
6-12 months 24%
Don’t know 24%
More than a year 21%
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 45% 0% 5% 3% 0% 3%
b. Assuring the medication history is accurate 39% 3% 13% 0% 0% 3%
c. Reconciling medications between the history and the admission orders 42% 3% 18% 0% 0% 3%
d. Reconciling medications upon transfer of a patient to another level of care 42% 3% 18% 0% 0% 0%
e. Reconciling medications at the time of discharge 34% 0% 18% 0% 0% 3%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 29% 0% 8% 3% 3% 8%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 19%
24 19%
36 5%
48 11%
Not Sure 16%
Other 30%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 61%
Not Sure 17%
Yes 22%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 18%
Computer charting system 11%
Not documented 16%
Not sure 16%
Paper chart 39%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 18%
Never 50%
Not Sure 13%
Sometimes 18%
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 32%
2 16%
3 8%
4 5%
5 16%
6 8%
7 5%
8 8%
i. Unreliable patient
1 27%
2 19%
3 14%
4 3%
5 11%
6 8%
7 14%
8 5%
ii. Clearly defined protocols
1 16%
2 16%
3 19%
4 16%
5 11%
6 5%
7 11%
8 5%
ii. Documentation from other sources
1 24%
2 8%
3 11%
4 16%
5 19%
6 3%
7 11%
8 8%
iii. Centralized history form/screen
1 22%
2 19%
3 8%
4 19%
5 6%
6 8%
7 11%
8 6%
iii. Lack of teamwork among disciplines
1 8%
2 25%
3 17%
4 11%
5 14%
6 8%
7 8%
8 8%
iv. History collection by pharmacist
1 8%
2 6%
3 8%
4 3%
5 8%
6 14%
7 17%
8 36%
iv. Extra burden
1 5%
2 14%
3 11%
4 16%
5 19%
6 14%
7 16%
8 5%
v. Easy communication with outpatient providers
1 16%
2 11%
3 5%
4 8%
5 11%
6 27%
7 14%
8 8%
v. Lack of frontline staff input into process
1 11%
2 14%
3 14%
4 8%
5 6%
6 17%
7 19%
8 11%
vi. Reasonable expectations for “complete” history
1 14%
2 22%
3 16%
4 14%
5 16%
6 5%
7 5%
8 8%
vi. Lack of administrative leadership 
1 11%
2 11%
3 11%
4 17%
5 14%
6 6%
7 19%
8 11%
vii. Awareness of the role of each contributor
1 14%
2 14%
3 14%
4 27%
5 11%
6 8%
7 11%
8 3%
vii. Lack of physician leadership
1 17%
2 8%
3 8%
4 14%
5 17%
6 17%
7 8%
8 11%
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:

2 6%

3 17%

4 17%
5 61%

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