ISMP Survey on Medication Reconciliation

discharges : More than a year Total: 257
About you
1. What is your profession?
Nurse 68%
Other 5%
Pharmacist 23%
Physician/prescriber 4%
2. What is your staffing level?
Administrator 9%
Manager 39%
Other 22%
Staff 30%
3. Are you familiar with the JC NPSG related to medication reconciliation? 93% - Yes 7% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 77% - Yes 23% - No
About your facility
5. In what type of facility are you employed?
Assisted living 1%
Home care 9%
Hospital 75%
Long term care 4%
Other 3%
Outpatient/office-based facility 5%
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 5%
1-3 months 9%
3-6 months 11%
6-12 months 9%
Don’t know 3%
More than a year 63%
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 8%
1-3 months 9%
3-6 months 11%
6-12 months 11%
Don’t know 7%
More than a year 55%
8. For discharges from your care, how long has a medication reconciliation process been in place on your unit/in your department/facility?   
More than a year 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 84% 7% 26% 1% 4% 0%
b. Assuring the medication history is accurate 72% 20% 39% 1% 4% 3%
c. Reconciling medications between the history and the admission orders 66% 24% 40% 1% 2% 3%
d. Reconciling medications upon transfer of a patient to another level of care 64% 20% 46% 1% 2% 3%
e. Reconciling medications at the time of discharge 69% 16% 49% 0% 1% 2%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 52% 4% 16% 11% 14% 15%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 11%
24 40%
36 1%
48 4%
Not Sure 26%
Other 18%
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 32%
Yes 16%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 29%
Computer charting system 18%
Not documented 4%
Not sure 3%
Paper chart 46%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 32%
Never 45%
Not Sure 6%
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 56%
2 18%
3 9%
4 6%
5 3%
6 4%
7 3%
8 2%
i. Unreliable patient
1 46%
2 17%
3 12%
4 8%
5 5%
6 2%
7 7%
8 3%
ii. Clearly defined protocols
1 37%
2 23%
3 16%
4 9%
5 6%
6 4%
7 1%
8 3%
ii. Documentation from other sources
1 24%
2 20%
3 17%
4 13%
5 10%
6 8%
7 6%
8 2%
iii. Centralized history form/screen
1 32%
2 20%
3 15%
4 11%
5 8%
6 6%
7 6%
8 3%
iii. Lack of teamwork among disciplines
1 29%
2 18%
3 17%
4 12%
5 8%
6 6%
7 5%
8 6%
iv. History collection by pharmacist
1 12%
2 8%
3 9%
4 13%
5 11%
6 9%
7 17%
8 21%
iv. Extra burden
1 19%
2 14%
3 15%
4 17%
5 9%
6 7%
7 9%
8 10%
v. Easy communication with outpatient providers
1 20%
2 11%
3 10%
4 13%
5 13%
6 18%
7 10%
8 4%
v. Lack of frontline staff input into process
1 14%
2 15%
3 13%
4 16%
5 14%
6 12%
7 8%
8 7%
vi. Reasonable expectations for “complete” history
1 24%
2 20%
3 14%
4 10%
5 12%
6 10%
7 7%
8 2%
vi. Lack of administrative leadership 
1 14%
2 10%
3 8%
4 7%
5 14%
6 18%
7 16%
8 13%
vii. Awareness of the role of each contributor
1 27%
2 14%
3 13%
4 13%
5 9%
6 10%
7 10%
8 4%
vii. Lack of physician leadership
1 28%
2 13%
3 11%
4 11%
5 8%
6 8%
7 13%
8 8%
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 4%

3 5%

4 20%
5 68%

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