Automated medication reconciliation and complexity of care transitions.
Medication reconciliation is a National Patient Safety Goal (NPSG) from The Joint Commission (TJC) that entails reviewing all medications a patient takes after a health care transition. Medication reconciliation is a resource-intensive, error-prone task, and the resources to accomplish it may not be routinely available. Computer-based methods have the potential to overcome these barriers. We designed and explored a rule-based medication reconciliation algorithm to accomplish this task across different healthcare transitions. We tested our algorithm on a random sample of 94 transitions from the Clinical Data Warehouse at the University of Texas Health Science Center at Houston. We found that the algorithm reconciled, on average, 23.4% of the potentially reconcilable medications. Our study did not have sufficient statistical power to establish whether the kind of transition affects reconcilability. We conclude that automated reconciliation is possible and will help accomplish the NPSG. (+info)
The ABC of handover: a qualitative study to develop a new tool for handover in the emergency department.
An institution-wide handoff task force to standardise and improve physician handoffs.
BACKGROUND: Transfers of care have become increasingly frequent and complex with shorter inpatient stays and changes in work hour regulations. Potential hazards exist with transfers. There are few reports of institution-wide efforts to improve handoffs. METHODS: An institution-wide physician handoff task force was developed to proactively address issues surrounding handoffs and to ensure a consistent approach to handoffs across the institution. RESULTS: This report discusses the authors' experiences with handoff standardisation, provider utilisation of a new electronic medical record-based handoff tool, and implementation of an educational curriculum; future work in developing hospital-wide policies and procedures for transfers; and the authors' consensus on the best methods for monitoring and evaluation of trainee handoffs. CONCLUSION: The handoff task force infrastructure has enabled the authors to take an institution-wide approach to improving handoffs. The task force has improved patient care by addressing handoffs systematically and consistently and has helped create new strategies for minimising risk in handoffs. (+info)
Outcomes for resident-identified high-risk patients and resident perspectives of year-end continuity clinic handoffs.