ISMP Survey on Medication Reconciliation

discharges : 0 months Total: 199
About you
1. What is your profession?
Nurse 58%
Other 7%
Pharmacist 31%
Physician/prescriber 4%
2. What is your staffing level?
Administrator 11%
Manager 37%
Other 20%
Staff 32%
3. Are you familiar with the JC NPSG related to medication reconciliation? 90% - Yes 10% - 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 3%
Home care 4%
Hospital 76%
Long term care 2%
Other 6%
Outpatient/office-based facility 7%
Surgery center 3%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 37%
1-3 months 20%
3-6 months 17%
6-12 months 16%
Don’t know 2%
More than a year 8%
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 55%
1-3 months 12%
3-6 months 6%
6-12 months 13%
Don’t know 3%
More than a year 12%
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 100%
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 72% 7% 31% 2% 2% 3%
b. Assuring the medication history is accurate 54% 21% 39% 1% 2% 7%
c. Reconciling medications between the history and the admission orders 39% 25% 44% 1% 2% 9%
d. Reconciling medications upon transfer of a patient to another level of care 43% 18% 43% 0% 3% 11%
e. Reconciling medications at the time of discharge 39% 8% 42% 1% 3% 19%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 29% 2% 14% 8% 9% 35%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 9%
24 33%
36 4%
48 5%
Not Sure 35%
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 52%
Not Sure 33%
Yes 15%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 22%
Computer charting system 16%
Not documented 9%
Not sure 9%
Paper chart 45%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 29%
Never 45%
Not Sure 11%
Sometimes 15%
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 45%
2 18%
3 12%
4 10%
5 3%
6 4%
7 4%
8 4%
i. Unreliable patient
1 30%
2 17%
3 10%
4 16%
5 9%
6 7%
7 7%
8 3%
ii. Clearly defined protocols
1 34%
2 25%
3 11%
4 9%
5 11%
6 4%
7 2%
8 4%
ii. Documentation from other sources
1 13%
2 20%
3 15%
4 16%
5 9%
6 14%
7 7%
8 6%
iii. Centralized history form/screen
1 24%
2 20%
3 13%
4 14%
5 9%
6 9%
7 4%
8 6%
iii. Lack of teamwork among disciplines
1 24%
2 15%
3 20%
4 11%
5 11%
6 6%
7 10%
8 3%
iv. History collection by pharmacist
1 9%
2 6%
3 8%
4 12%
5 11%
6 16%
7 22%
8 17%
iv. Extra burden
1 23%
2 18%
3 13%
4 13%
5 12%
6 8%
7 9%
8 4%
v. Easy communication with outpatient providers
1 12%
2 14%
3 9%
4 16%
5 12%
6 16%
7 15%
8 5%
v. Lack of frontline staff input into process
1 12%
2 14%
3 11%
4 12%
5 14%
6 16%
7 15%
8 6%
vi. Reasonable expectations for “complete” history
1 17%
2 15%
3 18%
4 17%
5 11%
6 13%
7 6%
8 3%
vi. Lack of administrative leadership 
1 13%
2 13%
3 15%
4 8%
5 9%
6 16%
7 14%
8 11%
vii. Awareness of the role of each contributor
1 15%
2 17%
3 20%
4 12%
5 12%
6 12%
7 7%
8 6%
vii. Lack of physician leadership
1 28%
2 18%
3 10%
4 11%
5 11%
6 8%
7 8%
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 3%

2 7%

3 8%

4 24%
5 58%

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