ISMP Survey on Medication Reconciliation

Staff Total: 554
About you
1. What is your profession?
Nurse 81%
Other 3%
Pharmacist 13%
Physician/prescriber 3%
2. What is your staffing level?
Staff 100%
3. Are you familiar with the JC NPSG related to medication reconciliation? 82% - Yes 18% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 55% - Yes 45% - No
About your facility
5. In what type of facility are you employed?
Assisted living 1%
Home care 5%
Hospital 82%
Long term care 1%
Other 3%
Outpatient/office-based facility 6%
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 7%
1-3 months 17%
3-6 months 25%
6-12 months 16%
Don’t know 20%
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? 
0 months 12%
1-3 months 17%
3-6 months 19%
6-12 months 15%
Don’t know 24%
More than a year 14%
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 12%
1-3 months 17%
3-6 months 18%
6-12 months 12%
Don’t know 27%
More than a year 14%
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% 5% 30% 2% 2% 1%
b. Assuring the medication history is accurate 74% 19% 39% 1% 2% 4%
c. Reconciling medications between the history and the admission orders 64% 22% 40% 1% 1% 6%
d. Reconciling medications upon transfer of a patient to another level of care 65% 19% 40% 1% 1% 8%
e. Reconciling medications at the time of discharge 64% 11% 44% 1% 1% 10%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 41% 5% 18% 7% 6% 30%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 11%
24 32%
36 2%
48 3%
Not Sure 46%
Other 7%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 35%
Not Sure 55%
Yes 10%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 20%
Computer charting system 18%
Not documented 5%
Not sure 10%
Paper chart 48%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 25%
Never 46%
Not Sure 12%
Sometimes 16%
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 54%
2 15%
3 10%
4 7%
5 4%
6 3%
7 3%
8 4%
i. Unreliable patient
1 50%
2 15%
3 10%
4 7%
5 5%
6 4%
7 5%
8 5%
ii. Clearly defined protocols
1 39%
2 21%
3 13%
4 8%
5 6%
6 5%
7 4%
8 3%
ii. Documentation from other sources
1 24%
2 20%
3 14%
4 14%
5 10%
6 8%
7 6%
8 5%
iii. Centralized history form/screen
1 34%
2 18%
3 16%
4 11%
5 5%
6 5%
7 7%
8 4%
iii. Lack of teamwork among disciplines
1 31%
2 16%
3 16%
4 11%
5 8%
6 7%
7 6%
8 4%
iv. History collection by pharmacist
1 15%
2 7%
3 10%
4 13%
5 13%
6 10%
7 17%
8 16%
iv. Extra burden
1 20%
2 15%
3 14%
4 14%
5 9%
6 8%
7 11%
8 8%
v. Easy communication with outpatient providers
1 18%
2 14%
3 12%
4 14%
5 12%
6 15%
7 11%
8 5%
v. Lack of frontline staff input into process
1 22%
2 14%
3 12%
4 14%
5 13%
6 11%
7 8%
8 6%
vi. Reasonable expectations for “complete” history
1 28%
2 18%
3 12%
4 12%
5 10%
6 10%
7 7%
8 3%
vi. Lack of administrative leadership 
1 17%
2 11%
3 12%
4 13%
5 12%
6 13%
7 14%
8 7%
vii. Awareness of the role of each contributor
1 25%
2 18%
3 10%
4 12%
5 9%
6 11%
7 11%
8 4%
vii. Lack of physician leadership
1 27%
2 14%
3 12%
4 14%
5 9%
6 10%
7 9%
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 5%

2 7%

3 12%

4 20%
5 57%

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