Pharmacist–Physician Collaboration to Improve the Accuracy of Medication Information in Electronic Medical Discharge Summaries: Effectiveness and Sustainability

Elliott, Rohan A; Tan, Yixin; Chan, Vincent; Richardson, Belinda; Tanner, Francine; Dorevitch, Michael I

doi:10.3390/pharmacy8010002

Cited by 11 publications

(17 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The nineteen articles (Additional file 10 ) were published between 2006 and 2020. Seven articles covered all three elements of interest to this review; design, implementation and use of PERMs [ 29 – 35 ]. Four articles considered only design [ 36 – 39 ], four considered only implementation [ 40 – 43 ] and the remaining four considered only use [ 44 – 47 ].…”

Section: Resultsmentioning

confidence: 99%

Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review

Waldron

Cahill

Cromie

et al. 2021

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.

show abstract

Section: Resultsmentioning

confidence: 99%

Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review

Waldron

Cahill

Cromie

et al. 2021

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

show abstract

“…A DS was considered accurate when the medications listed matched the discharge prescription, including medication name, formulation, dose, frequency and route and when there were no omissions or duplications. This method has been used elsewhere in the assessment of DS medication errors 4,6 . Any discrepancies between DS and prescription were considered errors.…”

Section: Methodsmentioning

confidence: 99%

Improving medicine information on discharge summaries through implementation of a reconciliation‐based intervention

Nguyen

Gibson

Wembridge

2022

Pharmacy Practice and Res

View full text Add to dashboard Cite

The handover of medication-related information at the point of discharge often occurs via the discharge summary (DS), although these frequently contain errors. We aimed to investigate whether an intern pharmacist reviewing the medication details in discharge summaries (DSs), reconciling them with the discharge prescription and pointing out any discrepancies with the medical staff would reduce the rate of medication errors. The intervention was retrospectively reviewed by comparing medication information on the DS with the discharge prescription (considered the 'source of truth'). Error rates on the DS were compared to a control group of patients discharged over a different 2-week period from the same ward. A modified APINCH (Antimicrobials, Potassium and other electrolytes, Insulin, Narcotics and other sedatives, Chemotherapeutic agents, Heparin and other anticoagulants, Systems) classification system was used to identify high-risk errors. The time taken to perform the intervention was measured and details of any recommendations collected. The study included 22 intervention patients and 31 control patients. Patients who received the intervention were less likely to have one or more medication errors on their DS (any: 4% vs 84%, p < 0.01; high-risk: 0% vs 29%, p < 0.01). The intern pharmacist made a total of 77 recommendations during the intervention. Six recommendations (8%) related to high-risk medications. The median time required to undertake the first review was 4 min, and the second review took 1 min. In conclusion, we found a reconciliation-based intervention involving an intern pharmacist could reduce the rate of medication errors on DSs.

show abstract

“…The nineteen articles (Additional File 10) were published between 2006 and 2020. Seven articles covered all three elements of interest to this review; design, implementation and use of PERMs (26)(27)(28)(29)(30)(31)(32). Four articles considered only design (33)(34)(35)(36), four considered only implementation (37)(38)(39)(40) and the remaining four considered only use (41)(42)(43)(44).…”

Section: Description Of Datasetmentioning

confidence: 99%

Personal Electronic Records of Medications (PERMs) for Medication Reconciliation at Care Transitions: A Rapid Realist Review

Waldron

Cahill

Cromie

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology: We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results: Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions: This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.

show abstract

Pharmacist–Physician Collaboration to Improve the Accuracy of Medication Information in Electronic Medical Discharge Summaries: Effectiveness and Sustainability

Cited by 11 publications

References 33 publications

Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review

Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review

Improving medicine information on discharge summaries through implementation of a reconciliation‐based intervention

Personal Electronic Records of Medications (PERMs) for Medication Reconciliation at Care Transitions: A Rapid Realist Review

Contact Info

Product

Resources

About