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Medication reconciliation is a formal process in which healthcare providers work together with patients, families and care providers to ensure accurate and comprehensive medication information is communicated consistently across transitions of care.
Medication reconciliation requires a systematic and comprehensive review of all the medications a patient is taking (known as a BPMH) to ensure that medications being added, changed or discontinued are carefully evaluated. It is a component of medication management and will inform and enable prescribers to make the most appropriate prescribing decisions for the patient.
"[Medication Reconciliation] is definitely the right thing to do. We have certainly caught errors that could have caused harm to patients, which helps staff and physicians better understand the importance of MedRec."
Winnipeg Regional Health Authority, MB
A Best Possible Medication History (BPMH) is a history created using 1) a systematic process of interviewing the patient/family; and 2) a review of at least one other reliable source of information to obtain and verify all of a patient's medication use (prescribed and non-prescribed). Complete documentation includes drug name, dosage, route and frequency. The BPMH is more comprehensive than a routine primary medication history which is often a quick preliminary medication history which may not include multiple sources of information. The BPMH is a 'snapshot' of the patient's actual medication use, which may be different from what is contained in their records. This is why the patient involvement is vital. 
ISMP Canada supports Medication Reconciliation provincially, nationally and internationally ISMP Canada created Getting Started Kits for Medication Reconciliation in Acute Care, Long Term Care, Home Care for the Canadian Safer Healthcare Now! campaign and for the World Health Organization High 5's initiative and provides ongoing support to teams around the world. Best Possible Medication History (BPMH) training is available. Read More … Experienced a MedRec failure? Report the medication incident to ISMP Canada. |
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Ontario
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Medication Communication Failures Impact EVERYONE! Poster and consensus statement from Canadian Healthcare leaders (English) (Français) National Survey: Identifying Practice Leaders for Medication Reconciliation in Canada (English) (Français) ISMP Canada is co-leading, with CPSI, the National Medication Reconciliation Strategy and is pleased to support the Canada Health Infoway ImagineNation Outcomes Challenge. National Summit: Optimizing Medication Safety at Care Transitions (English) (Français)
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ISMP Canada is the Protocol Lead for the World Health Organization (WHO) High 5s Medication Reconciliation Program: 'Assuring Medication Accuracy at Transitions in Care'. High 5s Project Overview Fact Sheet (English) (Français) Standardized Operating Protocols (SOPs) Find out more … |
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Provincial
Linking MedsCheck to MedRec - June 2009 With the support of the Ontario Ministry of Health and Long-Term Care (MOHLTC) and the Ontario Pharmacy Council, the Institute for Safe Medication Practices Canada (ISMP Canada) developed and delivered a pilot program to link the community-based MedsCheck program with medication reconciliation programs in hospitals. The goal of this collaborative initiative between hospitals and community pharmacists was to obtain the Best Possible Medication History (BPMH) for patients preparing to be admitted to hospital for surgery. Linking MedsCheck to MedRec Report (PDF) Optimizing Communication about Medications at Transitions of Care in Ontario - September, 2010 In the spring of 2010, ISMP Canada, in collaboration with the Canadian Society of Hospital Pharmacists Ontario Branch, hosted two invitational roundtable sessions. The overall goal of the sessions was to discuss opportunities and create recommendations to fully understand and utilize the drivers and resources that exist in Ontario to facilitate communication of medication information at transitions of care. Optimizing Communication about Medications at Transitions of Care in Ontario Report (PDF) Medication reconciliation at all interfaces of care - Pilot Project 2011/2012 Will provide a model for other institutions to adapt.
Medication Reconciliation at discharge - Pilot Project 2011/2012 Will provide a model for other institutions to adapt.
Tools for Discharge Medication Reconciliation:
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National
NATIONAL MEDICATION RECONCILIATION STRATEGY Co-lead by ISMP Canada and CPSI. A Year in Review This 2011 year end review reports on the progress of the National Medication Reconciliation (MedRec) Strategy. The accomplishments to date are significant, but we clearly acknowledge there is much work left to do. Improving communications about medications is a critical aspect of providing safer care and involves healthcare leaders, practitioners, and the public we serve. Your continued involvement will help ensure MedRec is a standard practice across the Canadian healthcare system. Medication Communication Failures Impact EVERYONE! Poster Medication Safety: We all have a role to play. The poster defines the impact of the Patient and Family, Healthcare System and Society in the communication of medications and includes an inter-professional joint statement, endorsed by 11 Canadian Healthcare organizations. This statement reflects the unique inter-professional ownership of this complex process, positioning Canada as a leader in this collaborative approach to professional engagement in support of medication reconciliation. Identifying Practice Leaders for Medication Reconciliation in Canada To facilitate understanding of the current landscape of medication reconciliation (MedRec) in Canada a survey of healthcare organizations was conducted between July and November of 2011. The purpose of the survey was to identify challenges and success factors in implementation of this key aspect of patient safety and to collect an inventory of tools and resources that contributed to this success. National Summit: Optimizing Medication Safety at Care Transitions - February 10, 2011 On February 10, 2011 healthcare leaders from across the country gathered in Toronto to carve out strategies and identify solutions/ best practices for improving communication to reduce preventable medication errors during transitions of care, one of the country's biggest patient safety issues. ISMP Canada and CPSI will together create a national steering committee to ensure the recommendations identified at the summit are implemented. Canada Health Infoway ImagineNation Outcomes Challenge Canada Health Infoway seeks to accelerate the use and spread of innovative solutions in healthcare information and communication technologies. They have selected four key areas with the potential to improve health care quality and the patient experience in Canada. 1. e-Scheduling 2. Patient access to health information 3. Medication reconciliation 4. Clinical synoptic reporting Up to $1 million in awards are being offered through this team-based Challenge to demonstrate the use and growth of e-solutions. ISMP Canada is a supporting organization for the ImagineNation Outcomes Challenge, providing expertise related to medication reconciliation. More information is available from: www.imaginenationchallenge.ca ISMP Canada Safety Bulletins:
SafeMedicationUse Newsletter: Safer Healthcare Now! ISMP Canada is the Intervention Lead for medication reconciliation in the successful Safer Healthcare Now! network. ISMP Canada supports Canadian teams in acute care, long term care, and home care implement medication reconciliation and optimize communication about medications across transitions of care. Getting Started Kits for Medication Reconciliation have been created for Acute Care, Long Term Care and Home Care. These kits provide guidance to implement medication reconciliation. The Community of Practice for Medication Reconciliation facilitates sharing and learning among practitioners across Canada. Activities include posting the latest articles, website links and tools contributed by individuals and teams participating in SHN. If you wish to sign up for SHN or participate in the Community of Practice for Medication Reconciliation, please go to the Safer Healthcare Now! website at www.saferhealthcarenow.ca.
Safer Healthcare Now! Progress Reports:
Medication Reconciliation in Acute Care Hundreds of Canadian teams are implementing medication reconciliation in acute care. Although this began as a response to Accreditation Canada Required Organizational Practices (ROP's) teams that are successful would never return to previous practices.
Success Stories:
Medication Reconciliation in Long-Term Care ISMP Canada identifies the proactive medication reconciliation model as being the most desirable in Long-term Care.
Success Stories: Medication Reconciliation in Home Care The Home Care Getting Started Kit is the result of a partnership between VON Canada, CPSI and ISMP Canada. A pilot project including 20 teams from across Canada identified that more than 40% of clients had one or more discrepancies among various sources of information.
Videos: Success Stories: Additional Posters and Guides:
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International - WHO High 5s Medication Reconciliation Program: Assuring Medication Accuracy at Transitions in Care
ISMP Canada is honoured to be the Protocol Lead for the World Health Organization (WHO) High 5s Medication Reconciliation Program: 'Assuring Medication Accuracy at Transitions in Care'. What is the High 5s Project? The High 5s Project was launched by the World Health Organization (WHO) in 2006 to address continuing major concerns about patient safety around the world. The High 5s name derives from the Project's original intent to significantly reduce the frequency of 5 challenging patient safety problems in 5 countries over 5 years. The Mission of the High 5s Project is to facilitate implementation and evaluation of standardized patient safety solutions within a global learning community to achieve measurable, significant and sustainable reductions in challenging patient safety problems. The High 5s Project is a patient safety collaboration among a group of countries and the WHO Collaborating Centre for Patient Safety in support of the WHO Patient Safety Programme. High 5s Project Overview Fact Sheet (English) (Français) Scope of the High 5s The major components of the High 5s Project include the development and implementation of problem-specific Standardized Operating Protocols (SOPs); creation of a comprehensive Impact Evaluation Strategy; collection of data, reporting and analysis; and the establishment of an electronic collaborative learning community. The Medication Reconciliation Protocol was developed by the Institute for Safe Medication Practices in Canada (ISMP Canada) and the Canadian Patient Safety Institute (CPSI). The High 5s Project is designed to generate learning that will permit the continuous refinement and improvement of the SOPs, as well as assessment of the feasibility and success of implementing standardized approaches to specific patient safety problems across multiple countries and cultures. Achievement of the Project goals is expected to provide valuable lessons and new knowledge to support the advancement of patient safety around the world. |
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National MedRec Webinars March 27, 2012 Development and Implementation of a MedRec e-BPMH Training Package: The Sunnybrook Health Sciences Centre Experience at 12 noon EDT. Join the Call April 10, 2012 Focusing on Quality MedRec Processes: Saskatoon Health Region's Approach at 12 noon EDT. Join the Call Jump into MedRec: Improving BPMH Quality across the Continuum of Care Learning Objectives: The Best Possible Medication History (BPMH) is the cornerstone of medication reconciliation. At the end of the session, participants will have:
The content of the workshop is tailored to meet the needs of the participants and their respective healthcare sectors. Who should attend? Physicians, Pharmacists, Pharmacy Technicians, Registered Nurses, and Registered Practical Nurses Length: 3 hours Cost: $65/person; (Ontario $35/person with support from MOHLTC). This program has been approved by the Ontario College of Pharmacists and awarded 3 CEUs Further Information: If you would like to arrange a BPMH Training session in your organization, please email education@ismp-canada.org Queens University Medication Reconciliation eLearning module Medication Reconciliation: A Learning Guide an online eLearning module created by Queens University to provide healthcare providers with the basic knowledge and understanding to successfully incorporate medication reconciliation in your daily practice as a team. Sunnybrook's BPMH eLearning Training Package! This Sunnybrook created BPMH eLearning Training Package! facilitates the training of personnel involved in the collection of BPMHs and educates trainees on the importance of medication reconciliation in advancing patient safety. |
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Contact Us
Provincial Kimindra Tiwana - KTiwana@ismp-canada.org National
Marg Colquhoun - mcolquhoun@ismp-canada.org International
Marg Colquhoun - mcolquhoun@ismp-canada.org |
