MedicineReconciliation
Network
Pamela Mills
Principal Pharmacist – Redesign
SPSP Fellow
Vice Chair Medicine Reconciliation Network
Scottish Patient Safety Programme
• Rolled out to all Acute hospitals in 2008• 5 key workstreams
– Leadership– Critical Care– General Ward– Peri-operative– Medicines Management
Reduce mortality by 15%Reduce adverse events by 30%
Medicine Reconciliation Network
• Multiprofessional reference network– Synergy and support– Sharing of best practice and wicked problems– Testing new ideas– Looking for solutions to share
Established Sept 2011
Challenges
• Multiple professions involved• Information available• Time to complete accurately• Admission rates• Prescribing errors• Transcription/ duplication• Scotland and rest of world
Medicine Reconciliation Process
Medication historyMedicine
ReconciliationInpatient
prescription sheet
July August September October November December January February March April May June35
40
45
50
55
60
65
70
75
80
85
average number emergency admissions per day
2011-2012
2010-2011
2009-2010
2008-2009
2007-2008
2006-2007
2005-2006
2004-2005
2003-2004
2002-2003
2001-2002
2000-2001
1999-2000
1998-9
Challenges
• Med Rec report not “user friendly”
• Not consistent process – access & printing
• Accuracy of information
• Certain medicines not included
Redesign of ECS Report
• Patient Name, CHI, DOB • Patient name on all pages• Allergies• Medicines in alphabetical order• Remove dressings, catheters, needles etc• Comments column• Space under each row- changes• 10 empty rows at bottom• Compliance aid• Details of completion
Scotland Consultation
Health Board Agreement?
Ayrshire and Arran Yes
Borders Yes
Dumfries & Galloway N/A
Fife Yes
Golden Jubilee N/A
Grampian Yes
Greater Glasgow & Clyde Yes
Highlands Yes
Lanarkshire Yes
Lothian Yes
Orkney N/A
Shetland N/A
Tayside Yes
Western Isles N/A
24 Yes