Julie B Cooper1, Michelle Lilliston2, DeAnne Brooks2, Bruce Swords2. 1. Julie B. Cooper, Pharm.D., BCPS, is Clinical Pharmacist; Michelle, Lilliston, Pharm.D., BCPS, is Clinical Pharmacist; and DeAnne Brooks, Pharm.D., is Director of Pharmacy, Moses H. Cone Memorial Hospital, Cone Health, Greensboro, NC. Bruce Swords, M.D., Ph.D., is Chief Medical Information Officer, Cone Health. julie.cooper@conehealth.com. 2. Julie B. Cooper, Pharm.D., BCPS, is Clinical Pharmacist; Michelle, Lilliston, Pharm.D., BCPS, is Clinical Pharmacist; and DeAnne Brooks, Pharm.D., is Director of Pharmacy, Moses H. Cone Memorial Hospital, Cone Health, Greensboro, NC. Bruce Swords, M.D., Ph.D., is Chief Medical Information Officer, Cone Health.
Abstract
PURPOSE: The implementation and outcomes of a pharmacy technician medication history program are described. SUMMARY: An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. CONCLUSION: A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation.
PURPOSE: The implementation and outcomes of a pharmacy technician medication history program are described. SUMMARY: An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. CONCLUSION: A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation.