ISMP Survey on Medication Reconciliation

Outpatient/office-based facility Total: 77
About you
1. What is your profession?
Nurse 64%
Other 12%
Pharmacist 9%
Physician/prescriber 16%
2. What is your staffing level?
Administrator 17%
Manager 24%
Other 17%
Staff 42%
3. Are you familiar with the JC NPSG related to medication reconciliation? 86% - Yes 14% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 62% - Yes 38% - No
About your facility
5. In what type of facility are you employed?
Outpatient/office-based facility 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 15%
1-3 months 13%
3-6 months 22%
6-12 months 8%
Don’t know 31%
More than a year 11%
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 13%
1-3 months 11%
3-6 months 10%
6-12 months 15%
Don’t know 35%
More than a year 15%
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 18%
1-3 months 19%
3-6 months 5%
6-12 months 11%
Don’t know 27%
More than a year 19%
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 43% 5% 23% 3% 6% 0%
b. Assuring the medication history is accurate 29% 6% 35% 1% 3% 4%
c. Reconciling medications between the history and the admission orders 25% 12% 27% 4% 4% 6%
d. Reconciling medications upon transfer of a patient to another level of care 30% 5% 21% 1% 3% 8%
e. Reconciling medications at the time of discharge 25% 9% 25% 1% 4% 10%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 19% 4% 14% 6% 6% 14%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 13%
24 11%
36 4%
48 11%
Not Sure 41%
Other 21%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 25%
Not Sure 67%
Yes 8%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 21%
Computer charting system 29%
Not documented 8%
Not sure 18%
Paper chart 25%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 31%
Never 39%
Not Sure 13%
Sometimes 17%
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 45%
2 9%
3 7%
4 7%
5 9%
6 4%
7 7%
8 12%
i. Unreliable patient
1 40%
2 19%
3 10%
4 5%
5 7%
6 7%
7 5%
8 7%
ii. Clearly defined protocols
1 26%
2 21%
3 7%
4 6%
5 15%
6 6%
7 8%
8 11%
ii. Documentation from other sources
1 19%
2 23%
3 16%
4 11%
5 8%
6 8%
7 7%
8 7%
iii. Centralized history form/screen
1 22%
2 15%
3 17%
4 10%
5 10%
6 7%
7 14%
8 6%
iii. Lack of teamwork among disciplines
1 24%
2 18%
3 17%
4 8%
5 11%
6 3%
7 7%
8 13%
iv. History collection by pharmacist
1 11%
2 10%
3 6%
4 22%
5 8%
6 13%
7 18%
8 13%
iv. Extra burden
1 10%
2 12%
3 19%
4 7%
5 11%
6 10%
7 15%
8 16%
v. Easy communication with outpatient providers
1 15%
2 19%
3 15%
4 13%
5 11%
6 14%
7 6%
8 7%
v. Lack of frontline staff input into process
1 12%
2 14%
3 12%
4 14%
5 14%
6 8%
7 12%
8 14%
vi. Reasonable expectations for “complete” history
1 18%
2 23%
3 15%
4 12%
5 5%
6 9%
7 8%
8 9%
vi. Lack of administrative leadership 
1 10%
2 10%
3 8%
4 12%
5 12%
6 15%
7 19%
8 14%
vii. Awareness of the role of each contributor
1 18%
2 10%
3 19%
4 10%
5 8%
6 10%
7 12%
8 14%
vii. Lack of physician leadership
1 13%
2 15%
3 8%
4 17%
5 8%
6 14%
7 17%
8 8%
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 6%

2 3%

3 17%

4 11%
5 64%

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