ISMP Survey on Medication Reconciliation

admissions: 6-12 months Total: 298
About you
1. What is your profession?
Nurse 71%
Other 5%
Pharmacist 20%
Physician/prescriber 4%
2. What is your staffing level?
Administrator 14%
Manager 36%
Other 20%
Staff 30%
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? 86% - Yes 14% - No
About your facility
5. In what type of facility are you employed?
Assisted living 2%
Home care 4%
Hospital 84%
Long term care 1%
Other 2%
Outpatient/office-based facility 2%
Surgery center 4%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
6-12 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 11%
1-3 months 7%
3-6 months 11%
6-12 months 56%
Don’t know 4%
More than a year 9%
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 7%
3-6 months 10%
6-12 months 57%
Don’t know 7%
More than a year 8%
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 88% 3% 24% 0% 3% 0%
b. Assuring the medication history is accurate 76% 17% 39% 0% 2% 1%
c. Reconciling medications between the history and the admission orders 64% 23% 45% 0% 2% 1%
d. Reconciling medications upon transfer of a patient to another level of care 64% 19% 47% 0% 1% 2%
e. Reconciling medications at the time of discharge 65% 8% 56% 0% 1% 1%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 48% 3% 15% 8% 8% 21%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 13%
24 43%
36 1%
48 3%
Not Sure 25%
Other 15%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 60%
Not Sure 26%
Yes 14%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 23%
Computer charting system 12%
Not documented 4%
Not sure 4%
Paper chart 57%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 34%
Never 43%
Not Sure 7%
Sometimes 16%
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 52%
2 18%
3 10%
4 6%
5 6%
6 2%
7 3%
8 3%
i. Unreliable patient
1 44%
2 17%
3 9%
4 7%
5 6%
6 8%
7 4%
8 4%
ii. Clearly defined protocols
1 39%
2 23%
3 10%
4 12%
5 5%
6 4%
7 4%
8 3%
ii. Documentation from other sources
1 16%
2 20%
3 15%
4 14%
5 11%
6 12%
7 8%
8 3%
iii. Centralized history form/screen
1 30%
2 18%
3 19%
4 11%
5 10%
6 5%
7 5%
8 3%
iii. Lack of teamwork among disciplines
1 30%
2 17%
3 13%
4 13%
5 11%
6 7%
7 6%
8 3%
iv. History collection by pharmacist
1 9%
2 8%
3 8%
4 11%
5 9%
6 12%
7 24%
8 19%
iv. Extra burden
1 22%
2 17%
3 13%
4 13%
5 13%
6 9%
7 9%
8 5%
v. Easy communication with outpatient providers
1 16%
2 11%
3 8%
4 13%
5 13%
6 21%
7 14%
8 4%
v. Lack of frontline staff input into process
1 16%
2 14%
3 14%
4 11%
5 15%
6 14%
7 10%
8 5%
vi. Reasonable expectations for “complete” history
1 23%
2 18%
3 16%
4 15%
5 13%
6 10%
7 4%
8 1%
vi. Lack of administrative leadership 
1 16%
2 12%
3 12%
4 6%
5 10%
6 12%
7 20%
8 10%
vii. Awareness of the role of each contributor
1 22%
2 18%
3 15%
4 14%
5 9%
6 9%
7 8%
8 3%
vii. Lack of physician leadership
1 31%
2 16%
3 11%
4 11%
5 6%
6 9%
7 9%
8 6%
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 5%

3 10%

4 17%
5 64%

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