ISMP Survey on Medication Reconciliation

transfers : 6-12 months Total: 268
About you
1. What is your profession?
Nurse 65%
Other 5%
Pharmacist 24%
Physician/prescriber 5%
2. What is your staffing level?
Administrator 16%
Manager 37%
Other 17%
Staff 30%
3. Are you familiar with the JC NPSG related to medication reconciliation? 97% - Yes 3% - 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 3%
Home care 4%
Hospital 84%
Long term care 1%
Other 3%
Outpatient/office-based facility 4%
Surgery center 1%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 3%
1-3 months 5%
3-6 months 12%
6-12 months 63%
Don’t know 2%
More than a year 15%
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? 
6-12 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 10%
1-3 months 9%
3-6 months 10%
6-12 months 55%
Don’t know 6%
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 85% 4% 22% 1% 2% 0%
b. Assuring the medication history is accurate 72% 20% 37% 1% 1% 1%
c. Reconciling medications between the history and the admission orders 59% 28% 42% 0% 1% 2%
d. Reconciling medications upon transfer of a patient to another level of care 62% 22% 48% 0% 1% 1%
e. Reconciling medications at the time of discharge 64% 10% 54% 0% 1% 2%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 49% 3% 14% 8% 9% 18%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 15%
24 40%
36 3%
48 5%
Not Sure 23%
Other 14%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 53%
Not Sure 27%
Yes 20%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 29%
Computer charting system 13%
Not documented 4%
Not sure 5%
Paper chart 49%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 30%
Never 44%
Not Sure 6%
Sometimes 20%
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 17%
3 10%
4 9%
5 5%
6 3%
7 3%
8 3%
i. Unreliable patient
1 41%
2 17%
3 8%
4 9%
5 8%
6 6%
7 5%
8 5%
ii. Clearly defined protocols
1 35%
2 23%
3 10%
4 11%
5 7%
6 5%
7 5%
8 4%
ii. Documentation from other sources
1 19%
2 19%
3 14%
4 14%
5 11%
6 12%
7 8%
8 3%
iii. Centralized history form/screen
1 30%
2 19%
3 17%
4 12%
5 7%
6 7%
7 5%
8 3%
iii. Lack of teamwork among disciplines
1 31%
2 15%
3 13%
4 12%
5 10%
6 7%
7 8%
8 4%
iv. History collection by pharmacist
1 11%
2 7%
3 6%
4 10%
5 15%
6 12%
7 21%
8 18%
iv. Extra burden
1 20%
2 17%
3 15%
4 13%
5 11%
6 11%
7 8%
8 4%
v. Easy communication with outpatient providers
1 15%
2 14%
3 12%
4 13%
5 12%
6 17%
7 12%
8 5%
v. Lack of frontline staff input into process
1 16%
2 13%
3 16%
4 14%
5 13%
6 15%
7 8%
8 5%
vi. Reasonable expectations for “complete” history
1 22%
2 19%
3 15%
4 16%
5 11%
6 8%
7 6%
8 3%
vi. Lack of administrative leadership 
1 15%
2 10%
3 14%
4 8%
5 14%
6 9%
7 22%
8 8%
vii. Awareness of the role of each contributor
1 20%
2 19%
3 18%
4 12%
5 9%
6 11%
7 8%
8 3%
vii. Lack of physician leadership
1 31%
2 16%
3 12%
4 12%
5 7%
6 6%
7 9%
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 1%

2 6%

3 10%

4 22%
5 62%

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