Alcântara TDS, Lima HF, Valença-Feitosa F, Aires-Moreno GT, Santos GAD, Araujo DC, Cavalcante-Santos LM, Cunha LC, Lyra DPD. Development and implementation of a medication reconciliation during pediatric transitions of care in a public hospital.
J Am Pharm Assoc (2003) 2021;
62:1400-1406.e3. [PMID:
34998691 DOI:
10.1016/j.japh.2021.12.009]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/19/2021] [Accepted: 12/16/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES
To generate effective changes in the work processes of an institution, such as hospitals, strategies are needed for the implementation of services. These should be based on the needs of the practice scenario and evidence that may develop programs applied to the routine of health care. This study aimed to implement medication reconciliation (MR) at the transition of care in the pediatric department of a public hospital located in Northeast Brazil.
SETTING
A step-by-step approach was adopted to implement MR in the studied hospital and conducted from March 2019 to December 2019.
PRACTICE INNOVATION
The implementation of MR used the "Model for Improvement" framework. The processes were built and tested in the Plan-Do-Study-Act (PDSA) cycles. Children admitted to the hospital's pediatrics department were included in the study. The objective of the PDSA cycles was to reach 75% of the patients included, with the service performed in at least one transition of care episode.
EVALUATION
This study used the following indicators: number of steps performed, number of discrepancies identified, and resolution of discrepancies. Descriptive statistical analysis was performed for all variables.
RESULTS
In the first cycle, all patients (n = 34) had the best possible medication history (BPMH) completed, and 26.4% went through all the MR stages. Seventy-two discrepancies were identified and 90.3% of them were resolved. In the second cycle, all patients (n = 35) had the BPMH completed, and 20% went through all the stages. A total of 32 discrepancies were identified and 96.8% of them were resolved. In the third cycle, all patients (n = 30) had the BPMH completed, and 56.6% of patients went through all the stages. Twenty-four discrepancies were identified and resolved.
CONCLUSION
The use of the "Model for Improvement" framework effectively contributed to the implementation of the service according to the characteristics of the studied hospital.
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