In the first two parts of this series we reviewed the fact that although medication reconciliation is recognized as being extremely challenging, there was progress being made in 2011. Some of that progress, the prototype user experience, earned a standing ovation from physician leadership in HCIT.
In this post, we will wrap up the topic by discussing the provider organizational process issues, where the many critical contexts of medication reconciliation (MR or Med Rec) come together. We’ll draw heavily from a presentation by Vickie Kamataris of Novaces in which she effectively peeled back the layers of the MR onion with great clarity. Titled “Medication Reconciliation: Putting a Dent in One of Healthcare’s Toughest Problems,” and delivered in August 2011, you’ll find it here.
Kamataris has the talent, skills and experience stemming from her nursing and Six Sigma master black belt training to make some very intelligent points. What follows are the fundamental dimensions and implications for action from her presentation.
A. Unreliable Med Rec is recurrently identifiable as the root cause of every major inpatient process failure. That’s true for preventable readmissions, attainment of quality goals, personal time and energy management of healthcare providers (especially nurses and doctors). Also included are avoidable waste such as non-value-added activities, and the effective management of transitions of care (admission and discharge being the granddaddies).
Implication: The Med Rec process must be understood and addressed as a prerequisite to any inpatient improvement project. This requires the correct use of tools, as shown in the figure above.