MEDICATION RECONCILIATION PROCESS

The steps of data collection:

ID eligible client

(Target Population)

Newly discharged within the past 7 days from

The MonctonHospital living in the Moncton/Riverview area.

Patient name, discharge date and Medicare number (identifier)

recorded by Intake Coordinator on Excelspread sheet which is

available to trained clinicians on Departmental S Drive

Trained clinicians choose anidentified client from excel spread sheet

Positive Med/RATto be recorded on Excel Spread Sheet

Select as Sample patient?

No? (If negative MedRAT)Yes? (If positive MedRAT)

Gather information from

  • the community pharmacy (fax list of medications filled in the past year)
  • medication calendars ( hospital discharge process)
  • client prescription labels
  • Extra Mural Referral
  • Hospital MAR on day of discharge from acute care setting

Interview Client

Record meds in BPMH

Compare Information gathered above with what patient states he/she is actually doing in their home setting. Complete “as stated by patient” section on ExtraMural SHN BPMH form

Document the information (medication list including discrepancies/omissions) on the ExtraMural Pilot SHN BPMH form .

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INITIATE RECONCILIATION

1. Decide urgency of Reconciliation

2. Decide on the method of reconciliation

High Urgent:

  • Call physician and fax form/tool
  • Direct client to physician/emergency department

Low Urgent:

Send completed BPMH form affixed with “letter to MD” to explain project and responsibilities of the MD to the physician. Mail via internal hospital mail system.

Label hospital internal mail brown envelope

Withauxiliary label “Return once completed to ------(use trained clinician name) “

Photocopy of ExtraMural SHN BPMH form is attached over the current drug profile sheet or in place of the current drug profile sheet if trained clinician is first team member in to do a medication history.

Complete

MEDICATION RECONCILIATION IN HOME CARE CLIENT DATA COLLECTION TOOL

Hand completed tool to co- team leader Susan Crawford to

Fax a copy to Margaret Meier to be recorded on

Master Data Collection Tool to send monthly to Toronto

DELIVERY OF MOST UP TO DATE MEDICATION RECORD TO CLIENT

  1. Physician reviews BPMH including identified discrepancies.
  2. Physician adjusts list, signs and returns to organization for placement in client’s record
  3. Primary clinician monitors progress
  4. Most up to date medication record is reviewed with client and placed on client chart.

BPMH returned by physician and placed on client chart

as most up to date Medication Record