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Admission Medication Reconciliation at Lions Gate Hospital. Lean Transformation Services Laarnie St-Laurent, Lean Coordinator Lorelei Grosser, Lean Coordinator Carissa Looman, Lean Educator. Objectives: What is MedRec ? Why do MedRec ? How was MedRec implemented?

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admission medication reconciliation at lions gate hospital

AdmissionMedication Reconciliation at Lions Gate Hospital

Lean Transformation Services

Laarnie St-Laurent, Lean Coordinator

Lorelei Grosser, Lean Coordinator

Carissa Looman, Lean Educator

admission medrec at lions gate hospital

Objectives:

  • What is MedRec?
  • Why do MedRec?
  • How was MedRec implemented?
    • Brief overview of Lean Methodology
    • How Lean was used for implementation
  • How are we doing now?
    • Audit Results
  • What are key “lessons learned?”
    • Impacts of MedRec

Admission MedRec at Lions Gate Hospital

slide3

Admission MedRec at Lions Gate Hospital

  • Ever wondered…
  • Right medication?
    • Right dose?
      • Right time?
slide5

Admission MedRec at Lions Gate Hospital

  • What is MedRec?

“Best Possible” Medication History

Reconciliation (Orders)

Pharmanet

(Prescribed Drugs)

slide6

Admission MedRec at Lions Gate Hospital

  • Why do MedRec?
  • Did you know…
  • “40-50% of patients on admission” are at risk of unintentional medication discrepancies?
    • Medication errors may harm patients
    • Of these, 6% are at risk of harm serious enough to increase length of stay from 2-8 days2.
slide7

Admission MedRec at Lions Gate Hospital

  • Why do MedRec?
  • Some Local Data
  • At Lions Gate:
    • About 38.8 daily admissions
    • 12.5 patients at risk of unintentional discrepancies
      • 0.75 patients daily at risk of staying 2 to 8 days longer
      • About $246K additional costs per year
    • (based on average cost of $450/patient/night)
steps to achieving continuous improvement sequence to approach the tools
Steps to Achieving Continuous Improvement– sequence to approach the tools

Continuous Improvement

  • -”Without Standards, there can be no improvement“ TaiichiOhno

Then:

Improve the Process

And Then:

Repeat!

First:

Understand the Current State

Rather than thinking specific tools do not apply, consider if their concept can provide benefit.

See for yourself & collect objective data that becomes the starting point for discussions

Adapted from Virginia Mason Lean Leader Certification Materials

slide9

VCH Improvement System

Lean Tollgate

Sustainment

Audit/Refine

Implementation/

Go-Live

Future State Development

Current State Analysis

Project Definition

LTS_VCH Improvement System_V1

slide10

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

Observations: Data Collection

slide11

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

Future State Value Stream Map

EmergNurse

EmergDoctor

Admission

Triage

  • BPMH documented by RN or Pharmacist on
  • MRP reconciles home medications
  • MedRec Order (MRO) form processed

MRO printed for certain areas in Emerg

slide12

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

Standard Operating Procedures:

Who

What

How

When

Why

slide13

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

slide14

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

Auditing and Breakthrough Lanes:

Did not meet MedRec criteria

Met MedRec criteria

slide15

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

Auditing and Breakthrough Lanes:

Why did not meet MedRec criteria?

slide16

Admission MedRec at Lions Gate Hospital

How was MedRec implemented?

Auditing and Breakthrough Lanes:

Did not meet MedRec?

Now what????

slide21

Admission MedRec at Lions Gate Hospital

How are we doing now?

Examples of “good saves” and Qualitative Results…

slide24

Admission MedRec at Lions Gate Hospital

  • Reference List:
  • 1 Canada. Accreditation Canada. Required Organization Practice. Ottawa: Accrediation Canada, 2012. Print.
  • 2 Canada. Optimizing Medication Safety at Care Transitions – Creating a National Challenge. Toronto: 2011. Print.
slide25

Admission MedRec at Lions Gate Hospital

Thank you for listening!

Questions???

slide26

Admission MedRec at Lions Gate Hospital

  • What is MedRec?

Systematic

Partnership

Conversation

slide27

Admission MedRec at Lions Gate Hospital

  • How was MedRec implemented?

5 Steps to Lean

Thinking

Source: James P. Womack. Lean Thinking.

slide28

Admission MedRec at Lions Gate Hospital

Medication Management

Paper flow

Audit & Refine

Implement