MEDICATION RECOCILIATION IN A PSYCHIATRIC HOSPITAL: A QUALITY IMPOROVEMENT PROJECT

Abstract

Medication reconciliation is considered to be an important aspect of safe prescription practice across all healthcare settings. This process aims to reconcile the medication lists of patients within specific care, based on available data and medication lists. However, the risk of errors is notable in medication lists, particularly when transitioning between care settings. Consequently, prescription errors and the omission of drugs and/or incorrect drug doses may pose a risk to patient safety. This quality improvement project focuses on the use of an evidence-based strategy to promote more robust medication reconciliation in the context of acute psychiatric care admissions. The proposed intervention was based on a literature search, wherein it was noted across seven studies that medication reconciliation performed at transitional care points may be valuable in reducing errors and promoting patient safety in psychiatric care. Accordingly, the use of a pharmacist-led intervention aimed at performing medication reconciliation prior to admission, during admission and upon discharge in psychiatric units is proposed. The intervention will be conducted in a local setting for a period of 12 weeks, providing an opportunity for sufficient data collection to inform the quasi-experimental method for evaluating quality improvement. Pharmacists will lead medication reconciliation and be involved in collaborative processes through which to discuss errors and reconcile these errors with psychiatric staff. Key barriers to the change process are discussed, including the potential challenges in feasibly performing these medication reconciliation episodes in the context of a busy ward environment. The role of transformational leadership in guiding the change process is discussed, along with detailed implementation of Kotter’s model of change. An evaluation of adherence to the change process, patient drug error rates, and safety outcomes are all considered to be potentially valuable in appraising the effectiveness of the intervention and the potential for future implementation of these strategies in psychiatric care settings