Medication reconciliation at admission and discharge: a time and motion study.
BMC Health Serv Res
; 13: 485, 2013 Nov 21.
Article
em En
| MEDLINE
| ID: mdl-24261516
ABSTRACT
BACKGROUND:
Medication reconciliation at admission, transfer and discharge has been designated as a required hospital practice to reduce adverse drug events. However, implementation challenges have resulted in poor hospital adherence. The aim of this study was to assess the processes required to carry out medication reconciliation the health professionals involved, the tasks and time devoted to medication reconciliation in general hospital settings.METHODS:
A time-and-motion study design was used. Using a systematic sample of patients admitted and discharged from geriatric, medical and surgical units in two academic centers, health professionals involved in medication reconciliation were observed and timed. Descriptive statistics were used to summarize the number of professionals involved, tasks performed, and mean time devoted.RESULTS:
Up to 3 professionals from 2 disciplines (medicine and pharmacy) were involved in the medication reconciliation process. Geriatric reconciliations took the most time to complete at admission (mean 92.2 minutes (SD = 44.3)) and discharge (mean 29.0 minutes (SD = 23.8)), followed by internal medicine at admission (mean 46.2 minutes (SD = 21.1)) and 19.4 (SD = 11.7) minutes at discharge) and general surgery minutes at discharge (mean 9.9 minutes (SD = 18.2)). Considerable differences in order, type and number of tasks performed were noted between and within units. Tasks independent of direct patient interaction took more than twice the time required to complete than tasks requiring patient interaction.CONCLUSION:
Lack of coordination, specialized training and agreement on the roles and responsibilities of professionals are among the most probable reasons for work-flow inefficiencies, possibly variability in quality, and time required for the current medication reconciliation process. A better understanding of the admission processes in general surgery is required. Standardization and use of electronic tools could improve efficiency and hospital adherence.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
/
Alta do Paciente
/
Reconciliação de Medicamentos
Limite:
Humans
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article