ISMP Survey on Medication Reconciliation

Manager Total: 538
About you
1. What is your profession?
Nurse 61%
Other 4%
Pharmacist 32%
Physician/prescriber 3%
2. What is your staffing level?
Manager 100%
3. Are you familiar with the JC NPSG related to medication reconciliation? 96% - Yes 4% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 85% - Yes 15% - No
About your facility
5. In what type of facility are you employed?
Assisted living 2%
Home care 3%
Hospital 83%
Long term care 3%
Other 2%
Outpatient/office-based facility 3%
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 8%
1-3 months 20%
3-6 months 30%
6-12 months 20%
Don’t know 4%
More than a year 18%
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 15%
1-3 months 17%
3-6 months 24%
6-12 months 18%
Don’t know 7%
More than a year 19%
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 14%
1-3 months 20%
3-6 months 25%
6-12 months 16%
Don’t know 6%
More than a year 18%
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 86% 7% 27% 1% 2% 0%
b. Assuring the medication history is accurate 71% 19% 42% 1% 1% 2%
c. Reconciling medications between the history and the admission orders 59% 25% 49% 0% 2% 2%
d. Reconciling medications upon transfer of a patient to another level of care 62% 20% 52% 0% 3% 2%
e. Reconciling medications at the time of discharge 63% 10% 55% 1% 2% 4%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 49% 2% 15% 10% 12% 18%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 12%
24 45%
36 2%
48 4%
Not Sure 21%
Other 16%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 57%
Not Sure 25%
Yes 17%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 26%
Computer charting system 12%
Not documented 3%
Not sure 3%
Paper chart 55%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 33%
Never 45%
Not Sure 8%
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 55%
2 16%
3 8%
4 4%
5 5%
6 4%
7 2%
8 5%
i. Unreliable patient
1 36%
2 15%
3 13%
4 10%
5 8%
6 8%
7 7%
8 3%
ii. Clearly defined protocols
1 37%
2 26%
3 11%
4 10%
5 6%
6 4%
7 3%
8 3%
ii. Documentation from other sources
1 17%
2 19%
3 18%
4 14%
5 14%
6 9%
7 7%
8 2%
iii. Centralized history form/screen
1 29%
2 19%
3 18%
4 12%
5 9%
6 5%
7 5%
8 3%
iii. Lack of teamwork among disciplines
1 27%
2 15%
3 16%
4 12%
5 11%
6 7%
7 8%
8 4%
iv. History collection by pharmacist
1 8%
2 6%
3 8%
4 10%
5 10%
6 12%
7 27%
8 18%
iv. Extra burden
1 21%
2 18%
3 12%
4 16%
5 11%
6 8%
7 10%
8 5%
v. Easy communication with outpatient providers
1 13%
2 13%
3 13%
4 11%
5 15%
6 18%
7 13%
8 4%
v. Lack of frontline staff input into process
1 15%
2 10%
3 16%
4 13%
5 14%
6 15%
7 11%
8 6%
vi. Reasonable expectations for “complete” history
1 19%
2 17%
3 17%
4 16%
5 13%
6 12%
7 4%
8 3%
vi. Lack of administrative leadership 
1 14%
2 12%
3 12%
4 8%
5 11%
6 13%
7 19%
8 10%
vii. Awareness of the role of each contributor
1 21%
2 17%
3 16%
4 15%
5 12%
6 8%
7 8%
8 4%
vii. Lack of physician leadership
1 29%
2 19%
3 11%
4 9%
5 8%
6 9%
7 9%
8 6%
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 2%

2 5%

3 10%

4 19%
5 63%

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