ISMP Survey on Medication Reconciliation

transfers : 0 months Total: 203
About you
1. What is your profession?
Nurse 64%
Other 5%
Pharmacist 28%
Physician/prescriber 3%
2. What is your staffing level?
Administrator 11%
Manager 39%
Other 17%
Staff 32%
3. Are you familiar with the JC NPSG related to medication reconciliation? 89% - Yes 11% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 65% - Yes 35% - No
About your facility
5. In what type of facility are you employed?
Assisted living 2%
Home care 4%
Hospital 80%
Long term care 2%
Other 4%
Outpatient/office-based facility 4%
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 38%
1-3 months 18%
3-6 months 20%
6-12 months 16%
Don’t know 2%
More than a year 6%
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 100%
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 54%
1-3 months 11%
3-6 months 12%
6-12 months 7%
Don’t know 5%
More than a year 10%
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 75% 7% 30% 1% 3% 2%
b. Assuring the medication history is accurate 58% 15% 40% 0% 2% 7%
c. Reconciling medications between the history and the admission orders 38% 18% 44% 0% 2% 12%
d. Reconciling medications upon transfer of a patient to another level of care 38% 10% 37% 0% 4% 17%
e. Reconciling medications at the time of discharge 47% 7% 47% 0% 2% 12%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 32% 1% 13% 6% 6% 36%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 9%
24 37%
36 3%
48 3%
Not Sure 39%
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 55%
Not Sure 34%
Yes 11%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 22%
Computer charting system 13%
Not documented 11%
Not sure 9%
Paper chart 46%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 25%
Never 47%
Not Sure 14%
Sometimes 14%
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 46%
2 18%
3 10%
4 5%
5 5%
6 4%
7 4%
8 7%
i. Unreliable patient
1 34%
2 16%
3 13%
4 10%
5 8%
6 7%
7 7%
8 6%
ii. Clearly defined protocols
1 32%
2 25%
3 15%
4 7%
5 6%
6 5%
7 4%
8 5%
ii. Documentation from other sources
1 16%
2 18%
3 17%
4 15%
5 10%
6 11%
7 7%
8 5%
iii. Centralized history form/screen
1 23%
2 23%
3 14%
4 13%
5 9%
6 7%
7 7%
8 5%
iii. Lack of teamwork among disciplines
1 23%
2 14%
3 17%
4 17%
5 9%
6 7%
7 7%
8 4%
iv. History collection by pharmacist
1 6%
2 2%
3 10%
4 17%
5 10%
6 14%
7 21%
8 20%
iv. Extra burden
1 26%
2 15%
3 9%
4 14%
5 11%
6 7%
7 12%
8 5%
v. Easy communication with outpatient providers
1 15%
2 12%
3 9%
4 13%
5 16%
6 17%
7 13%
8 4%
v. Lack of frontline staff input into process
1 15%
2 11%
3 13%
4 10%
5 18%
6 13%
7 10%
8 8%
vi. Reasonable expectations for “complete” history
1 20%
2 14%
3 18%
4 19%
5 10%
6 9%
7 6%
8 3%
vi. Lack of administrative leadership 
1 15%
2 14%
3 14%
4 9%
5 7%
6 14%
7 14%
8 12%
vii. Awareness of the role of each contributor
1 15%
2 13%
3 18%
4 14%
5 16%
6 12%
7 7%
8 5%
vii. Lack of physician leadership
1 31%
2 16%
3 10%
4 9%
5 8%
6 12%
7 7%
8 7%
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 5%

2 5%

3 10%

4 19%
5 61%

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