ISMP Survey on Medication Reconciliation

discharges : 6-12 months Total: 246
About you
1. What is your profession?
Nurse 69%
Other 6%
Pharmacist 20%
Physician/prescriber 5%
2. What is your staffing level?
Administrator 19%
Manager 35%
Other 20%
Staff 26%
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? 85% - Yes 15% - No
About your facility
5. In what type of facility are you employed?
Assisted living 2%
Home care 5%
Hospital 82%
Long term care 2%
Other 3%
Outpatient/office-based facility 3%
Surgery center 4%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 2%
1-3 months 3%
3-6 months 12%
6-12 months 69%
Don’t know 3%
More than a year 10%
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 6%
1-3 months 6%
3-6 months 11%
6-12 months 60%
Don’t know 4%
More than a year 13%
8. For discharges from your care, how long has a medication reconciliation process been in place on your unit/in your department/facility?   
6-12 months 100%
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 85% 3% 20% 0% 2% 0%
b. Assuring the medication history is accurate 75% 15% 35% 0% 1% 2%
c. Reconciling medications between the history and the admission orders 61% 25% 45% 0% 2% 1%
d. Reconciling medications upon transfer of a patient to another level of care 65% 18% 47% 0% 1% 2%
e. Reconciling medications at the time of discharge 65% 12% 54% 0% 1% 1%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 53% 2% 13% 8% 8% 17%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 15%
24 43%
36 2%
48 3%
Not Sure 23%
Other 13%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 60%
Not Sure 25%
Yes 15%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 27%
Computer charting system 12%
Not documented 2%
Not sure 5%
Paper chart 53%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 31%
Never 43%
Not Sure 8%
Sometimes 18%
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 48%
2 16%
3 11%
4 7%
5 7%
6 5%
7 4%
8 4%
i. Unreliable patient
1 40%
2 18%
3 7%
4 10%
5 8%
6 8%
7 4%
8 5%
ii. Clearly defined protocols
1 36%
2 23%
3 11%
4 10%
5 7%
6 4%
7 5%
8 4%
ii. Documentation from other sources
1 17%
2 20%
3 16%
4 16%
5 10%
6 9%
7 8%
8 4%
iii. Centralized history form/screen
1 31%
2 21%
3 16%
4 13%
5 8%
6 4%
7 4%
8 4%
iii. Lack of teamwork among disciplines
1 29%
2 14%
3 12%
4 12%
5 13%
6 8%
7 8%
8 5%
iv. History collection by pharmacist
1 10%
2 7%
3 9%
4 11%
5 12%
6 9%
7 21%
8 20%
iv. Extra burden
1 23%
2 16%
3 11%
4 13%
5 17%
6 10%
7 8%
8 3%
v. Easy communication with outpatient providers
1 14%
2 13%
3 11%
4 11%
5 14%
6 19%
7 12%
8 4%
v. Lack of frontline staff input into process
1 16%
2 15%
3 18%
4 11%
5 13%
6 16%
7 7%
8 5%
vi. Reasonable expectations for “complete” history
1 22%
2 19%
3 16%
4 18%
5 10%
6 7%
7 5%
8 3%
vi. Lack of administrative leadership 
1 16%
2 13%
3 12%
4 11%
5 11%
6 9%
7 22%
8 7%
vii. Awareness of the role of each contributor
1 22%
2 19%
3 14%
4 15%
5 10%
6 10%
7 7%
8 4%
vii. Lack of physician leadership
1 31%
2 19%
3 10%
4 10%
5 5%
6 11%
7 5%
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 1%

2 4%

3 11%

4 19%
5 65%

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