ISMP Survey on Medication Reconciliation

transfers : 1-6 months Total: 620
About you
1. What is your profession?
Nurse 71%
Other 5%
Pharmacist 20%
Physician/prescriber 4%
2. What is your staffing level?
Administrator 14%
Manager 36%
Other 18%
Staff 32%
3. Are you familiar with the JC NPSG related to medication reconciliation? 98% - Yes 2% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 86% - Yes 14% - No
About your facility
5. In what type of facility are you employed?
Assisted living 1%
Home care 3%
Hospital 87%
Long term care 2%
Other 2%
Outpatient/office-based facility 2%
Surgery center 2%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 3%
1-3 months 30%
3-6 months 50%
6-12 months 9%
Don’t know 2%
More than a year 6%
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? 
1-3 months 43%
3-6 months 57%
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 6%
1-3 months 32%
3-6 months 42%
6-12 months 7%
Don’t know 5%
More than a year 8%
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 86% 4% 25% 0% 1% 0%
b. Assuring the medication history is accurate 73% 18% 40% 1% 1% 1%
c. Reconciling medications between the history and the admission orders 60% 23% 50% 1% 1% 1%
d. Reconciling medications upon transfer of a patient to another level of care 64% 19% 52% 0% 1% 1%
e. Reconciling medications at the time of discharge 62% 10% 56% 0% 0% 3%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 48% 3% 17% 9% 9% 20%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 11%
24 47%
36 2%
48 4%
Not Sure 24%
Other 12%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 56%
Not Sure 31%
Yes 13%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 24%
Computer charting system 13%
Not documented 3%
Not sure 2%
Paper chart 59%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 34%
Never 43%
Not Sure 7%
Sometimes 16%
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 54%
2 14%
3 9%
4 7%
5 6%
6 4%
7 3%
8 4%
i. Unreliable patient
1 38%
2 16%
3 15%
4 9%
5 7%
6 5%
7 6%
8 4%
ii. Clearly defined protocols
1 38%
2 22%
3 13%
4 10%
5 7%
6 4%
7 3%
8 3%
ii. Documentation from other sources
1 16%
2 19%
3 16%
4 15%
5 14%
6 9%
7 8%
8 3%
iii. Centralized history form/screen
1 29%
2 19%
3 15%
4 13%
5 8%
6 6%
7 6%
8 4%
iii. Lack of teamwork among disciplines
1 29%
2 17%
3 15%
4 11%
5 11%
6 6%
7 7%
8 4%
iv. History collection by pharmacist
1 9%
2 8%
3 10%
4 9%
5 12%
6 11%
7 24%
8 17%
iv. Extra burden
1 21%
2 17%
3 14%
4 16%
5 11%
6 7%
7 9%
8 4%
v. Easy communication with outpatient providers
1 12%
2 12%
3 13%
4 13%
5 15%
6 18%
7 13%
8 4%
v. Lack of frontline staff input into process
1 17%
2 14%
3 14%
4 14%
5 11%
6 12%
7 12%
8 7%
vi. Reasonable expectations for “complete” history
1 21%
2 18%
3 16%
4 13%
5 13%
6 13%
7 5%
8 2%
vi. Lack of administrative leadership 
1 13%
2 13%
3 11%
4 12%
5 11%
6 14%
7 17%
8 9%
vii. Awareness of the role of each contributor
1 22%
2 19%
3 16%
4 10%
5 11%
6 8%
7 11%
8 4%
vii. Lack of physician leadership
1 29%
2 19%
3 12%
4 10%
5 8%
6 9%
7 8%
8 5%
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 2%

2 7%

3 10%

4 21%
5 60%

Copyright © 2012, ISMP. All rights reserved