ISMP Survey on Medication Reconciliation

admissions: 1-6 months Total: 732
About you
1. What is your profession?
Nurse 68%
Other 5%
Pharmacist 25%
Physician/prescriber 2%
2. What is your staffing level?
Administrator 14%
Manager 36%
Other 17%
Staff 32%
3. Are you familiar with the JC NPSG related to medication reconciliation? 98% - Yes 2% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 85% - Yes 15% - No
About your facility
5. In what type of facility are you employed?
Assisted living 1%
Home care 2%
Hospital 90%
Long term care 1%
Other 1%
Outpatient/office-based facility 3%
Surgery center 1%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
1-3 months 40%
3-6 months 60%
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 29%
3-6 months 39%
6-12 months 6%
Don’t know 4%
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 10%
1-3 months 32%
3-6 months 40%
6-12 months 5%
Don’t know 5%
More than a year 7%
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 86% 5% 27% 1% 1% 0%
b. Assuring the medication history is accurate 71% 19% 43% 1% 1% 1%
c. Reconciling medications between the history and the admission orders 56% 24% 49% 0% 1% 3%
d. Reconciling medications upon transfer of a patient to another level of care 59% 20% 52% 0% 2% 3%
e. Reconciling medications at the time of discharge 60% 10% 56% 0% 1% 5%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 45% 3% 16% 9% 10% 23%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 11%
24 49%
36 1%
48 4%
Not Sure 25%
Other 11%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 57%
Not Sure 31%
Yes 12%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 26%
Computer charting system 13%
Not documented 2%
Not sure 2%
Paper chart 57%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 31%
Never 44%
Not Sure 7%
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 53%
2 15%
3 9%
4 7%
5 5%
6 4%
7 3%
8 4%
i. Unreliable patient
1 35%
2 17%
3 15%
4 11%
5 7%
6 5%
7 6%
8 4%
ii. Clearly defined protocols
1 34%
2 24%
3 14%
4 10%
5 7%
6 5%
7 4%
8 3%
ii. Documentation from other sources
1 16%
2 18%
3 18%
4 14%
5 13%
6 10%
7 8%
8 3%
iii. Centralized history form/screen
1 29%
2 21%
3 14%
4 12%
5 8%
6 6%
7 5%
8 4%
iii. Lack of teamwork among disciplines
1 27%
2 15%
3 16%
4 13%
5 11%
6 6%
7 7%
8 5%
iv. History collection by pharmacist
1 10%
2 6%
3 9%
4 10%
5 13%
6 11%
7 24%
8 17%
iv. Extra burden
1 22%
2 17%
3 14%
4 16%
5 10%
6 7%
7 10%
8 4%
v. Easy communication with outpatient providers
1 12%
2 13%
3 14%
4 12%
5 14%
6 17%
7 15%
8 4%
v. Lack of frontline staff input into process
1 16%
2 13%
3 14%
4 14%
5 11%
6 14%
7 11%
8 7%
vi. Reasonable expectations for “complete” history
1 21%
2 17%
3 16%
4 16%
5 12%
6 11%
7 5%
8 3%
vi. Lack of administrative leadership 
1 12%
2 13%
3 11%
4 12%
5 14%
6 13%
7 16%
8 9%
vii. Awareness of the role of each contributor
1 21%
2 17%
3 16%
4 12%
5 12%
6 9%
7 9%
8 3%
vii. Lack of physician leadership
1 29%
2 19%
3 11%
4 11%
5 9%
6 10%
7 6%
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 2%

2 7%

3 11%

4 22%
5 58%

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