ISMP Survey on Medication Reconciliation

Hospital Total: 3782
About you
1. What is your profession?
Nurse 90%
Other 1%
Pharmacist 8%
Physician/prescriber 0%
2. What is your staffing level?
Administrator 4%
Manager 12%
Other 6%
Staff 78%
3. Are you familiar with the JC NPSG related to medication reconciliation? 31% - Yes 69% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 26% - Yes 74% - No
About your facility
5. In what type of facility are you employed?
Hospital 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 68%
1-3 months 7%
3-6 months 11%
6-12 months 7%
Don’t know 3%
More than a year 5%
7. For transfers to a different level of care, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 70%
1-3 months 6%
3-6 months 8%
6-12 months 6%
Don’t know 3%
More than a year 6%
8. For discharges from your care, how long has a medication reconciliation process been in place on your unit/in your department/facility?   
0 months 70%
1-3 months 7%
3-6 months 9%
6-12 months 5%
Don’t know 4%
More than a year 5%
About your process

9. Who is primarily responsible for the following (you may choose more than one category)…

Nurse Pharmacist Physician/ Prescriber Medical Records Other Don’t Know
a. Collecting an initial medication history 33% 3% 12% 2% 2% 2%
b. Assuring the medication history is accurate 27% 9% 17% 2% 2% 3%
c. Reconciling medications between the history and the admission orders 23% 11% 19% 2% 2% 3%
d. Reconciling medications upon transfer of a patient to another level of care 24% 9% 20% 2% 2% 3%
e. Reconciling medications at the time of discharge 24% 6% 22% 2% 2% 4%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 18% 3% 8% 5% 5% 10%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 70%
24 16%
36 0%
48 1%
Not Sure 10%
Other 4%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 84%
Not Sure 11%
Yes 4%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 8%
Computer charting system 4%
Not documented 1%
Not sure 2%
Paper chart 85%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 77%
Never 15%
Not Sure 3%
Sometimes 5%
14. Please rank the relative importance of success factors and barriers encountered during the implementation of the medication reconciliation program at your facility. Scale: 1=most important, 8=least important (use each number once in the ranking process).
a. SUCCESS FACTORS
Rank
b. BARRIERS
Rank
i. Teamwork among disciplines
1 85%
2 5%
3 3%
4 2%
5 2%
6 1%
7 1%
8 1%
i. Unreliable patient
1 80%
2 5%
3 4%
4 3%
5 2%
6 2%
7 2%
8 1%
ii. Clearly defined protocols
1 80%
2 8%
3 4%
4 3%
5 2%
6 1%
7 1%
8 1%
ii. Documentation from other sources
1 73%
2 6%
3 5%
4 5%
5 4%
6 3%
7 3%
8 1%
iii. Centralized history form/screen
1 77%
2 7%
3 5%
4 4%
5 2%
6 2%
7 1%
8 1%
iii. Lack of teamwork among disciplines
1 77%
2 5%
3 5%
4 4%
5 3%
6 2%
7 2%
8 1%
iv. History collection by pharmacist
1 71%
2 2%
3 3%
4 3%
5 4%
6 4%
7 7%
8 6%
iv. Extra burden
1 74%
2 6%
3 5%
4 5%
5 3%
6 3%
7 3%
8 2%
v. Easy communication with outpatient providers
1 71%
2 4%
3 4%
4 4%
5 5%
6 6%
7 4%
8 1%
v. Lack of frontline staff input into process
1 73%
2 4%
3 5%
4 4%
5 4%
6 5%
7 3%
8 2%
vi. Reasonable expectations for “complete” history
1 75%
2 6%
3 5%
4 5%
5 4%
6 3%
7 2%
8 1%
vi. Lack of administrative leadership 
1 72%
2 4%
3 4%
4 3%
5 4%
6 4%
7 6%
8 3%
vii. Awareness of the role of each contributor
1 75%
2 6%
3 5%
4 4%
5 4%
6 3%
7 3%
8 1%
vii. Lack of physician leadership
1 77%
2 6%
3 4%
4 3%
5 3%
6 3%
7 3%
8 2%
15. On a scale of 1 to 5, with 1=not valuable and 5=very valuable, please select a number below indicating your perception of the value of the medication reconciliation process to patient safety overall:

1 1%

2 69%

3 3%

4 7%
5 20%

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