Module 5-establishing a medication history hibernating taking service

Question 1

ADE
BPMH
EHR
ED
FTE
MARQUIS
MTM
NQF
QI
RN
SNF
Tech(s)

Answer 1

-Adverse drug event
-Best possible medication history.
-Electronic health record.
-Emergency department.
-full-time equivalent.
-multisite medication reconciliation quality improvement study.
-Medication therapy management.
-national Quality forum.
-quality improvement.
-Registered nurse
-skilled nurse facility
-Pharmacy technician

Question 2

-A multitude of decision to be made when planning a medication history program.
-make decisions with stakeholders input from beginning and threw out the life of the program.
-Senior leadership support is the key.
-Consider a pilot program
-walk through the process now
-Identify ‘pain’ point example point in the process of taking medication history that are problematic.
-Optimize the need of the institution

Answer 2

DECISIONS, DECISIONS

Question 3

-Location.
-staffing.
-Scoping.
-Prioritizing high risk patient

Answer 3

Decisions ,decision ,continue
-variation

Question 4

-ED-based pharmacy staff.
-Pharmacist/intern/
technician work in the ED
-unit-/floor-based pharmacy
staff
-pharmacist/interns/technicians work on specific units or floors
-Hybrid:
-Emphasis on taking medication histories for patient admitted through the ED
-Additional Pharmacist/interns/technicians who float to unit/floor:
-Follow up in complete history.
-Take history on patient directly admitted to the units of floor

Answer 4

APPROACHES IN THE HOSPITAL SETTING

Question 5

-many opportunity exist for Pharmacist, student pharmacist, and or pharmacy technician to obtain medication history from patient outside of the hospital.
-Outpatient setting
-Pharmacies

Answer 5

Approaching in outpatient setting

Question 6

-clinics— via phone prior to appointment, or immediately upon patient arrival prior to patient seeing medical provider, so that home medication list current when patients are seen.
-pre-operative— via phone or during the outpatient appointment prior to surgery
-utilizing pharmacist and or student pharmacist for pre-operative medication history, can also instruct patients regarding medication to hold pre-operatively

Answer 6

Outpatient setting: examples?

Question 7

Community-based/retail pharmacy -during medication therapy management (MTM) visit in person ,or telehealth visit, via phone
-mail order pharmacies— prior to medication refill being sent

Answer 7

Pharmacy-examples:

Question 8

-students pharmacist and pharmacy technician medication history taker we require oversight by Pharmacist
-Shift
-8 to 12 hours
-see xx patients per shift, even average medication history takes YY one minuteS
to complete
- staffs up for busiest times versus other responsibilities during less busy tones

Answer 8

Staffing

Question 9

WHY ARE PROGRAM STARTED?

Answer 9

You could utilize some data about medication discrepancies from quality improvement projects that demonstrate inaccuracies in the medication reconciliation process, particularly the history taking process
-Data about medication errors and adverse drug events or ADE’s originating from patients receiving incorrect home medication regiments indicating that medication history was optimal