ISMP Survey on Medication Reconciliation

admissions: 0 months Total: 122
About you
1. What is your profession?
Nurse 56%
Other 8%
Pharmacist 28%
Physician/prescriber 8%
2. What is your staffing level?
Administrator 16%
Manager 36%
Other 17%
Staff 30%
3. Are you familiar with the JC NPSG related to medication reconciliation? 78% - Yes 22% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 42% - Yes 58% - No
About your facility
5. In what type of facility are you employed?
Assisted living 2%
Home care 4%
Hospital 61%
Long term care 6%
Other 12%
Outpatient/office-based facility 9%
Surgery center 5%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 100%
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 62%
1-3 months 9%
3-6 months 7%
6-12 months 7%
Don’t know 5%
More than a year 11%
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 61%
1-3 months 8%
3-6 months 8%
6-12 months 5%
Don’t know 7%
More than a year 11%
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 58% 5% 25% 2% 4% 4%
b. Assuring the medication history is accurate 42% 11% 30% 2% 3% 11%
c. Reconciling medications between the history and the admission orders 30% 12% 33% 1% 2% 16%
d. Reconciling medications upon transfer of a patient to another level of care 36% 11% 31% 0% 1% 13%
e. Reconciling medications at the time of discharge 39% 9% 34% 0% 2% 13%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 32% 2% 16% 3% 6% 26%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 8%
24 20%
36 5%
48 4%
Not Sure 46%
Other 17%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 48%
Not Sure 41%
Yes 11%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 19%
Computer charting system 20%
Not documented 19%
Not sure 15%
Paper chart 26%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 21%
Never 45%
Not Sure 24%
Sometimes 10%
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 34%
2 17%
3 10%
4 9%
5 10%
6 7%
7 4%
8 9%
i. Unreliable patient
1 23%
2 15%
3 12%
4 13%
5 13%
6 10%
7 8%
8 6%
ii. Clearly defined protocols
1 31%
2 28%
3 8%
4 8%
5 8%
6 6%
7 6%
8 7%
ii. Documentation from other sources
1 15%
2 15%
3 12%
4 14%
5 15%
6 11%
7 11%
8 7%
iii. Centralized history form/screen
1 23%
2 20%
3 15%
4 10%
5 9%
6 7%
7 10%
8 7%
iii. Lack of teamwork among disciplines
1 21%
2 14%
3 18%
4 11%
5 13%
6 8%
7 10%
8 6%
iv. History collection by pharmacist
1 6%
2 7%
3 10%
4 15%
5 12%
6 13%
7 17%
8 21%
iv. Extra burden
1 22%
2 17%
3 7%
4 12%
5 10%
6 9%
7 16%
8 7%
v. Easy communication with outpatient providers
1 14%
2 14%
3 12%
4 13%
5 14%
6 18%
7 7%
8 8%
v. Lack of frontline staff input into process
1 17%
2 14%
3 12%
4 14%
5 13%
6 15%
7 9%
8 8%
vi. Reasonable expectations for “complete” history
1 15%
2 8%
3 18%
4 20%
5 11%
6 15%
7 10%
8 4%
vi. Lack of administrative leadership 
1 21%
2 13%
3 13%
4 12%
5 5%
6 13%
7 9%
8 14%
vii. Awareness of the role of each contributor
1 17%
2 13%
3 14%
4 13%
5 9%
6 14%
7 13%
8 7%
vii. Lack of physician leadership
1 23%
2 16%
3 11%
4 12%
5 8%
6 12%
7 10%
8 10%
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 4%

2 5%

3 10%

4 20%
5 61%

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