New Manual Helps Hospitals Improve Medication Reconciliation
The AHRQ-funded Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) has produced an implementation manual to help hospitals improve medication reconciliation practices. These improvements can lead to reductions in negative outcomes such as inpatient adverse drug events and readmission rates, which have significant patient safety and financial implications for hospitals. Based on the experiences of five hospitals participating in a three-year project conducted by the Society of Hospital Medicine,
MARQUIS identifies best practices for medication reconciliation processes throughout hospital admission, transfer and discharge. It also outlines a framework for assembling a team and developing an implementation strategy adaptable to any hospital system. The MARQUIS implementation manual explains how hospitals can implement a bundle of interventions to improve medication reconciliation using a quality improvement process. The manual includes a site assessment to help implementers understand where to start with the process. Site leaders or pharmacists can use this assessment to help gauge the patient-centeredness of the institution’s medication reconciliation process and begin customization and implementation of the various bundle components. The manual also features accompanying online resources such as a return on investment calculator to help hospitals make the business case for medication reconciliation.
AHRQ’s Web M&M Explores Complexities in Monitoring Fetal Health
The latest issue of AHRQ Web M&M features a Spotlight Case that examines the risks and benefits of monitoring fetal heart rate tracings during labor. It describes a 29-year-old woman who had an uncomplicated pregnancy with a healthy fetus and presented to the hospital at term (40 weeks) in early labor. She progressed slowly the first night, but the next morning she pushed for approximately two hours without any difficulty or any sign of problems with the fetus. Unfortunately, the newborn was cyanotic and flaccid with very low Apgar scores. The infant required extensive resuscitation but survived and was transferred to the neonatal intensive care unit. In addition, the Perspectives on Safety section features an interview with Mark Graban, M.S., M.B.A., an internationally recognized expert in Lean health care, about applying Lean principles in hospitals to improve safety and decrease waste. The Perspective section features a book excerpt by Paul E. Plsek, M.S., principal, Plsek & Associates, in Roswell, Georgia, describing how integrating innovation and Lean concepts at Virginia Mason Medical Center in Seattle enhanced clinical performance and the patient experience.
AHRQ’s Health Care Innovations Exchange Focuses on Reducing Non-Urgent Emergency Services
The latest issue of AHRQ’s Health Care Innovations Exchange focuses on the Exchange’s new Emergency Services Learning Community, featuring profiles about reducing the use of emergency services for non-urgent conditions. One of the profiles describes a program run by MedStar Mobile Healthcare, an emergency medical service provider in Fort Worth, Texas. MedStar uses mobile health care paramedics to provide in-home and telephone-based support to patients who frequently call 911 and to other patient populations who are at risk for potentially preventable admissions or readmissions. Four additional programs serve individuals with congestive heart failure, patients who can be managed transitionally at home versus with an overnight observational admission, in-home hospice patients who are at risk for hospice revocation and home health agencies as a support to prevent unnecessary visits to the emergency department. These programs have significantly reduced the number of 911 calls, potentially preventable emergency department visits and hospital admissions. This innovation is part of a cluster of select profiles in the Innovations Exchange’s Emergency Services Learning Community.