Medication reconciliation is an important aspect of managing a medical facility. These 3 best practices can help improve efficiency of your office.
Every doctor’s office, hospital and medical facility knows, or should know, the importance of medication reconciliation in preventing adverse drug events. There is a lot that has been said and that continues to be said about the issue, but a lot of it lacks actionable advice. To that end, here are three best practices that could benefit your office.
1. Doctor and Patient Medication Reviews
Medication reviews should be a must once a year, especially with older patients, but does not happen in many places. Office managers or lead doctors should figure out ways to establish reviews that work best with their office/system. For example, is there already an official patient safety program in place that could incorporate medication reviews? What percentage of patients is tech savvy and uses email?
A mailing (or email) can go to patients’ homes with paperwork on medication for patients to bring to the next visit. It would basically comprise a list of medications, including vitamins and supplements, dosages, and so on. This approach bestows the gift of time so that patients (and/or their caregivers) are able to think and make adjustments for a few days rather than answer unexpected questions during a doctor’s appointment. It is a gift of time for busy doctors as well.
Another factor to consider is when to do the reviews. If they are at least once a year, should the general office practice be to do them every five patient visits? After every hospitalization? Should the office encourage annual physicals that include medication reviews?
Information to discuss during the reviews (and on pre-meeting mailings) needs to include:
- A list and review of everything, with vitamins and supplements included
- Frequency of each dosage
- Methods of taking the medications (orally, etc.)
- The dosage amounts
- A discussion and printout of potential side effects and behavioral changes
Accuracy matters a lot in the answers, which is why all correspondence and discussion should explain the rationale behind the review. Statements such as, “Honesty is important here. If you haven’t been taking your medication as often as you should, or you’ve been taking it too often, please let me know. You would be far from alone, and I just want to make sure we are on the same page. No judgments.”
Offices should also have a system to track how their efforts are going. For instance, if the first-year goal is to have 35 percent of patients undergo review meetings, how many did occur? What was the patient feedback on these? Are there particular doctors who tend to skip the meetings, and what can be done to address that?
2. Medication Tracking Systems
When patients get hospitalized, are prescribed new medications and released, their primary care physicians may not always know. Likewise, upon hospitalization, a patient may not be able to immediately (or at all) supply a list of medications, method of administration, dosages and so on.
One solution to medication reconciliation is a proactive medication tracking system. Doctors’ offices can make them standard, for example, by giving patients a basic form to keep in their medical records and that they take to all appointments, meetings, hospitalizations and so on. For younger patients, an app may be easier—or even a simple email file (or file on the cloud) that lets patients make and track changes right from their smartphones. Depending on the level of tech, it is also possible for the system to sync with the doctor’s office. The tracking system should have space for a patient to note how he or she felt after a dosage change or medication change.
3. In-Office Medication System
Many medication errors—and medication reconciliation errors—occur because too many people get involved in a case. An in-office medication dispensing system enables you to dispense medication inside your office so patients don’t have to head to the pharmacy. Proficient RX offers an in-office dispensing service for a wide spectrum of medications, including antihistamines, NSAIDs, antibiotics, injectables, anti-anxiety, and muscle relaxants.
Your office gets another point of contact with the patient to increase convenience and reduce errors. Nothing gets lost in translation from the doctor to the pharmacist, and it is even possible that many of your patients would be getting all of their medications from you. All of the information would be on file.
With people living longer and babies surviving (and thriving) like they never could before, medication upon medication is a fact of life for many Americans. Medication reconciliation is even more important, and every doctor’s office should have a process for it.
Learn More about our in office dispensing services or contact us today to determine how we can best meet your needs!