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Regional Medical Center Success Story
Our facility (RMC, Manchester) committed to IHI 100,000Lives Campaign in the spring of 2005. Phase I included development of a tool to obtain as accurrate medication history as possible from the patient presenting in ER, OR, Ambulatory Surgery, Medical-Surgical and Intensive Care units. This tool was developed by the Patient Safety Committee, co-chaired by our Pharmacy and Quality Managers. This committee also has a physician champion that is very actively engaged in all of our patient safety initiatives. This tool is in triplicate, which also functions as a physician order sheet thus avoiding potential for transcription errors. This process has slowly but steadily evolved to the point that all physicians, nurses, and pharmacists are involved in the intended use of this document. From that, we developed a discharge record specific to medication the patient was to continue on at home following discharge. It is in larger print, and utilizes symbols like a stop sign that indicates to the patient what medications have been discontinued. A copy is sent to the physician’s office after the patient is discharged.
In the spring of 2006, our Patient Safety Committee, under the direction of our physician champion, and at the request of members of our Medical Staff, accepted the challenge to begin Phase II of 100,000Lives Campaign. Phase II involved marketing and engaging patients in our community to know what medications they were taking, why they were taking them, and how to take them. This involved the development of a medication card that could be given to patients at various access places from all medical providers, and businesses in our community. The committee reviewed the medication reconciliation tool kit that was available online from the Iowa Healthcare Collaborative. Having this toolkit available to us proved to be invaluable from the standpoint of not having to spend hours re-inventing the wheel. The committee reviewed the medication card and made the changes we felt most appropriate for our community. From there it was taken to our Medical Staff for further suggestions. Their direction and support was very encouraging, and they continued to push for a product that they could give and educate the patient/public on in relationship to them taking ownership of their medications.
The physicians asked for more space for medications to be written so the elderly patient could read and write on it, space for a brief medical/surgical history, and allergies that would fit into a male/female billfold. We decided to make ours slightly larger, with a different layout from the toolkit, and found that when folded properly we could fit it into a baseball card sleeve protector. These were less expensive than the ones suggested in the toolkit. The trade off was that the base ball sleeve was flimsier; but still effective. We placed our hospital logo on the sleeve, and saved a lot of room on the card itself. The final product with a full marketing plan was taken to our full Medical Staff in August. The Medical Staff unanimously voted to support this initiative, and voted to put $1000 from their fund to help with advertising and printing of the cards. The hospital and hospital auxiliary have equally donated funds to help sustain this project.
Manchester has a population of 6,000. Our service area is approximately 22,000 people. RMC hosted an Open House to members of this service area in September. One identified stop on the tour was our Medical Staff meeting room which contained a brief presentation on Medication Matters project and distribution of the cards. Over 600 cards were distributed that day. Since then, we have hosted a breakfast brunch for all medical providers (dentists, pharmacists, optometrists, chiropractors, physicians, mental health providers) in our area to promote this initiative and provide them with a holder and packet(obtained from the IHC website containing the medication card). All of the local pharmacies have also assisted with providing funds to educate and market this initiative on our local radio station and in the local newspapers. I have attached copies of these advertisements. To date over 5000 of the cards have been distributed by these providers. The hospital has committed to continue to be the contact and supplier of the medication cards for the participating providers. We have even developed an audiovox message regarding this initiative ( see attached),the message plays on our hospital phone system, so when a caller is on hold, we educate on the use of the card and where to obtain one. We have also had various written articles from our pharmacist in the local papers.
Hopefully, now we will see patients use the card……….so far we have seen some useage as people come in for surgery and scheduled procedures. There is still a lot of work to be done to educate the public. We monitor how many cards we distribute to each provider, so we can receive feedback on whether or not they are offering the card, and have it available to patients. Thanks again to the efforts of all the people involved in placing the toolkit on the IHC website!
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View the IHC toolkits and their contents.
Resources for providers to ensure safe and effective long-term anticoagulation therapy in all care settings.
Information on how to deploy the NQF 30 Safe Practices.
Information that discusses how to better communicate medical information to patients.
Information on the monitoring and reporting of HAIs.
This process improvement method can help providers deliver more efficient care that saves resources and improves quality.
Details on the principles and components of a patient centered medical home, including the business case and how to become one.
Resources for providers to avoid adverse drug events.
Resources for the safe administration of narcotics and opioids.
Information and resources for providers in their efforts to assist patients with tobacco cessation.
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