Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety
<p>Abstract</p> <p>Background</p> <p>Medication errors are a leading cause of patient harm. Many of these errors result from an incomplete overview of medication either at a patient’s referral to or at discharge from the hospital. One solution is medication reconciliati...
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| Format: | Article |
| Language: | English |
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BMC
2012-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1472-6963/12/170 |
| _version_ | 1828272181540290560 |
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| author | van Sluisveld Nelleke Zegers Marieke Natsch Stephanie Wollersheim Hub |
| author_facet | van Sluisveld Nelleke Zegers Marieke Natsch Stephanie Wollersheim Hub |
| author_sort | van Sluisveld Nelleke |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Medication errors are a leading cause of patient harm. Many of these errors result from an incomplete overview of medication either at a patient’s referral to or at discharge from the hospital. One solution is medication reconciliation, a formal process in which health care professionals partner with patients to ensure an accurate and complete transfer of medication information at interfaces of care. In 2007, the Dutch government compelled hospitals to implement a bundle concerning medication reconciliation at hospital admission and discharge. But to date many hospitals have failed to implement this bundle fully. The aim of this study was to gain insight into the barriers and drivers of the implementation process.</p> <p>Methods</p> <p>We performed face to face, semi-structured interviews with twenty health care professionals and managers from several departments at a 953 bed university hospital in the Netherlands and also from the surrounding community health services. The interviews were analysed using a combined theoretical framework of Grol and Cabana to classify the drivers and barriers identified.</p> <p>Results</p> <p>There is lack of awareness and insufficient knowledge of health care professionals about the health care problem and the bundle medication reconciliation. These result in a lack of support for implementing the bundle. In addition clinicians are reluctant to reallocate tasks to nurses or pharmacy technicians. Another major barrier is a lack of communication, understanding and collaboration between hospital and community caregivers. The introduction of more competitive market forces has made matters worse. Major drivers are a good implementation plan, patient awareness, and obligation by the government.</p> <p>Conclusions</p> <p>We identified a wide range of barriers and drivers which health care professionals believe influence the implementation of medication reconciliation. This reflects the complexity of implementation. Implementation can be improved if these factors are adequately addressed. The feasibility and effectiveness of these strategies should be tested in controlled trails.</p> |
| first_indexed | 2024-04-13T06:03:05Z |
| format | Article |
| id | doaj.art-53ba90c42ccb475eb098888cc3f80413 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T06:03:05Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-53ba90c42ccb475eb098888cc3f804132022-12-22T02:59:22ZengBMCBMC Health Services Research1472-69632012-06-0112117010.1186/1472-6963-12-170Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safetyvan Sluisveld NellekeZegers MariekeNatsch StephanieWollersheim Hub<p>Abstract</p> <p>Background</p> <p>Medication errors are a leading cause of patient harm. Many of these errors result from an incomplete overview of medication either at a patient’s referral to or at discharge from the hospital. One solution is medication reconciliation, a formal process in which health care professionals partner with patients to ensure an accurate and complete transfer of medication information at interfaces of care. In 2007, the Dutch government compelled hospitals to implement a bundle concerning medication reconciliation at hospital admission and discharge. But to date many hospitals have failed to implement this bundle fully. The aim of this study was to gain insight into the barriers and drivers of the implementation process.</p> <p>Methods</p> <p>We performed face to face, semi-structured interviews with twenty health care professionals and managers from several departments at a 953 bed university hospital in the Netherlands and also from the surrounding community health services. The interviews were analysed using a combined theoretical framework of Grol and Cabana to classify the drivers and barriers identified.</p> <p>Results</p> <p>There is lack of awareness and insufficient knowledge of health care professionals about the health care problem and the bundle medication reconciliation. These result in a lack of support for implementing the bundle. In addition clinicians are reluctant to reallocate tasks to nurses or pharmacy technicians. Another major barrier is a lack of communication, understanding and collaboration between hospital and community caregivers. The introduction of more competitive market forces has made matters worse. Major drivers are a good implementation plan, patient awareness, and obligation by the government.</p> <p>Conclusions</p> <p>We identified a wide range of barriers and drivers which health care professionals believe influence the implementation of medication reconciliation. This reflects the complexity of implementation. Implementation can be improved if these factors are adequately addressed. The feasibility and effectiveness of these strategies should be tested in controlled trails.</p>http://www.biomedcentral.com/1472-6963/12/170Adverse eventsSafetyQualityMedication reconciliationMedication errorImplementationImplementation barriers |
| spellingShingle | van Sluisveld Nelleke Zegers Marieke Natsch Stephanie Wollersheim Hub Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety BMC Health Services Research Adverse events Safety Quality Medication reconciliation Medication error Implementation Implementation barriers |
| title | Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety |
| title_full | Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety |
| title_fullStr | Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety |
| title_full_unstemmed | Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety |
| title_short | Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety |
| title_sort | medication reconciliation at hospital admission and discharge insufficient knowledge unclear task reallocation and lack of collaboration as major barriers to medication safety |
| topic | Adverse events Safety Quality Medication reconciliation Medication error Implementation Implementation barriers |
| url | http://www.biomedcentral.com/1472-6963/12/170 |
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