ISMP Survey on Medication Reconciliation

Physician/prescriber Total: 61
About you
1. What is your profession?
Physician/prescriber 100%
2. What is your staffing level?
Administrator 31%
Manager 26%
Other 18%
Staff 25%
3. Are you familiar with the JC NPSG related to medication reconciliation? 91% - Yes 9% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 64% - Yes 36% - No
About your facility
5. In what type of facility are you employed?
Assisted living 20%
Home care 8%
Hospital 26%
Long term care 5%
Other 10%
Outpatient/office-based facility 20%
Surgery center 11%
6. For admissions, 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 15%
6-12 months 20%
Don’t know 21%
More than a year 13%
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 10%
1-3 months 18%
3-6 months 18%
6-12 months 23%
Don’t know 15%
More than a year 16%
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 13%
1-3 months 18%
3-6 months 15%
6-12 months 21%
Don’t know 16%
More than a year 16%
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 13% 0% 11% 0% 0% 0%
b. Assuring the medication history is accurate 7% 2% 11% 0% 0% 0%
c. Reconciling medications between the history and the admission orders 8% 3% 10% 0% 0% 0%
d. Reconciling medications upon transfer of a patient to another level of care 8% 3% 11% 0% 0% 2%
e. Reconciling medications at the time of discharge 7% 2% 11% 0% 0% 2%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 8% 0% 2% 5% 3% 3%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 16%
24 13%
36 15%
48 15%
Not Sure 26%
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 45%
Not Sure 55%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 20%
Computer charting system 16%
Not documented 18%
Not sure 25%
Paper chart 21%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 30%
Never 28%
Not Sure 17%
Sometimes 25%
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 20%
2 21%
3 11%
4 8%
5 11%
6 5%
7 10%
8 13%
i. Unreliable patient
1 21%
2 20%
3 10%
4 10%
5 11%
6 7%
7 10%
8 11%
ii. Clearly defined protocols
1 21%
2 18%
3 10%
4 15%
5 11%
6 10%
7 8%
8 7%
ii. Documentation from other sources
1 15%
2 7%
3 18%
4 17%
5 5%
6 13%
7 12%
8 13%
iii. Centralized history form/screen
1 20%
2 20%
3 15%
4 5%
5 10%
6 10%
7 16%
8 5%
iii. Lack of teamwork among disciplines
1 12%
2 15%
3 15%
4 7%
5 18%
6 8%
7 13%
8 12%
iv. History collection by pharmacist
1 10%
2 12%
3 14%
4 10%
5 12%
6 12%
7 17%
8 14%
iv. Extra burden
1 15%
2 10%
3 13%
4 10%
5 13%
6 12%
7 20%
8 7%
v. Easy communication with outpatient providers
1 10%
2 10%
3 13%
4 15%
5 13%
6 16%
7 8%
8 15%
v. Lack of frontline staff input into process
1 10%
2 11%
3 11%
4 11%
5 7%
6 11%
7 25%
8 13%
vi. Reasonable expectations for “complete” history
1 10%
2 18%
3 20%
4 15%
5 7%
6 16%
7 7%
8 8%
vi. Lack of administrative leadership 
1 3%
2 10%
3 10%
4 15%
5 22%
6 17%
7 17%
8 7%
vii. Awareness of the role of each contributor
1 7%
2 21%
3 16%
4 15%
5 5%
6 11%
7 10%
8 15%
vii. Lack of physician leadership
1 15%
2 15%
3 11%
4 10%
5 15%
6 10%
7 11%
8 13%
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:

4 18%
5 82%

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