Pharmacy-Based Medication Reconciliation Program Utilizing Pharmacists and Technicians: A Process Improvement Initiative

Abstract

Background: Pharmacists and pharmacy technicians have an opportunity to impact the quality of the medication histories and improve patient safety by ensuring accurate medication lists are obtained and complete reconciliation has occurred with the admission medication orders by owning the admission medication reconciliation process. Objective: To compare the quality of a pharmacy-based medication reconciliation program on admission utilizing pharmacists and technicians to the usual multidisciplinary process. Methods: This was a retrospective chart review process improvement study at a 186-bed tertiary care inpatient facility. Primary outcomes included both the accuracy of pre-admission medications listed and the reconciliation of those medications with admission inpatient orders. Technicians obtained patient medication histories. Pharmacists checked the technician-obtained medication histories and ensured reconciliation of those medications with admission orders. Results: Medication accuracy increased from 45.8% to 95% per patient (P , .001) and medication reconciliation increased from 44.2% to 92.8% (P , .001) and remained above benchmark. Conclusion: A pharmacy-based medication reconciliation program utilizing both pharmacists and technicians significantly increased the accuracy and reconciliation of medications on admission. These gains were maintained for the duration of the 6-month period studied and beyond per continued process improvement data collection.

Trained student pharmacists' telephonic collection of patient medication information: Evaluation of a structured interview tool

“…The use of a tool to facilitate medication list collection is consistent with many other institutions utilizing support staff to conduct medication histories. 1,13,14,18,19 The end-user or pharmacists should be involved in the tool development process to ensure that key information needed to conduct the MTM session is collected during the interview. 19 …”

Report of the 2013-2014 Professional Affairs Standing Committee: Advancing the Pharmacy Profession Together through Pharmacy Technician and Pharmacy Education Partnerships

“…services (e.g., medication reconciliation, asthma education, smoking cessation, prescription error reduction, telepharmacy, drive-through pharmacy) 31,32,33,34,35,36,37 , importance of pharmacy technician credentialing for successful pharmacy services 38 , pharmacy technician roles to enhance pharmacy clinical and operational capabilities 39,40,41 , versus collaborations with pharmacy technician programs 42,43 or pharmacy technician-to-student pharmacist pathway programs. 44,45 In order to gather more information to address their second charge, the PAC chose to investigate the current relationships and successful practices between schools/ colleges of pharmacy and institutions engaged in pharmacy technician education.…”

Development of a collaborative transitions-of-care program for heart failure patients

“…10 This prompted PSPH administrators to review the hospital's processes and HF readmission rates. An opportunity was presented to the inpatient pharmacy administrators to evaluate methods for reducing medication errors related to hospital discharge and to identify strategies for improving its nurse-driven medication reconciliation process.…”