ISMP Survey on Medication Reconciliation

pharmacist Total: 346
About you
1. What is your profession?
Pharmacist 100%
2. What is your staffing level?
Administrator 14%
Manager 52%
Other 13%
Staff 22%
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? 84% - Yes 16% - No
About your facility
5. In what type of facility are you employed?
Assisted living 2%
Home care 2%
Hospital 87%
Long term care 2%
Other 3%
Outpatient/office-based facility 2%
Surgery center 2%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 10%
1-3 months 20%
3-6 months 33%
6-12 months 17%
Don’t know 2%
More than a year 18%
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 16%
1-3 months 15%
3-6 months 21%
6-12 months 19%
Don’t know 5%
More than a year 24%
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 18%
1-3 months 20%
3-6 months 23%
6-12 months 14%
Don’t know 8%
More than a year 17%
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 79% 8% 21% 0% 2% 0%
b. Assuring the medication history is accurate 58% 32% 39% 1% 1% 2%
c. Reconciling medications between the history and the admission orders 39% 38% 45% 0% 0% 3%
d. Reconciling medications upon transfer of a patient to another level of care 42% 33% 54% 1% 2% 3%
e. Reconciling medications at the time of discharge 48% 10% 56% 0% 1% 7%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 48% 2% 14% 8% 9% 20%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 8%
24 54%
36 2%
48 5%
Not Sure 19%
Other 13%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 68%
Not Sure 18%
Yes 14%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 27%
Computer charting system 12%
Not documented 5%
Not sure 2%
Paper chart 54%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 33%
Never 42%
Not Sure 8%
Sometimes 17%
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 51%
2 15%
3 10%
4 6%
5 6%
6 4%
7 4%
8 3%
i. Unreliable patient
1 25%
2 19%
3 16%
4 10%
5 9%
6 7%
7 9%
8 4%
ii. Clearly defined protocols
1 27%
2 26%
3 13%
4 12%
5 9%
6 6%
7 5%
8 3%
ii. Documentation from other sources
1 13%
2 16%
3 17%
4 16%
5 14%
6 11%
7 10%
8 3%
iii. Centralized history form/screen
1 23%
2 21%
3 19%
4 11%
5 8%
6 8%
7 6%
8 3%
iii. Lack of teamwork among disciplines
1 19%
2 16%
3 15%
4 12%
5 11%
6 11%
7 12%
8 4%
iv. History collection by pharmacist
1 8%
2 6%
3 6%
4 11%
5 17%
6 12%
7 25%
8 15%
iv. Extra burden
1 23%
2 20%
3 13%
4 16%
5 10%
6 6%
7 7%
8 5%
v. Easy communication with outpatient providers
1 8%
2 10%
3 14%
4 14%
5 15%
6 22%
7 14%
8 5%
v. Lack of frontline staff input into process
1 12%
2 11%
3 14%
4 16%
5 14%
6 16%
7 12%
8 5%
vi. Reasonable expectations for “complete” history
1 12%
2 15%
3 19%
4 19%
5 14%
6 12%
7 6%
8 2%
vi. Lack of administrative leadership 
1 12%
2 12%
3 14%
4 11%
5 11%
6 14%
7 19%
8 7%
vii. Awareness of the role of each contributor
1 12%
2 18%
3 17%
4 17%
5 12%
6 12%
7 9%
8 2%
vii. Lack of physician leadership
1 27%
2 15%
3 8%
4 14%
5 12%
6 11%
7 7%
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 1%

2 7%

3 10%

4 28%
5 55%

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