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Improving Patient Care with Medication Management
Improving Patient Care With Medication Management: Everything Clinicians Must Know

Not many days pass without new reports of frightening stories on medication errors that could — and should — have been avoided. In a best-case scenario, patients manage to escape no worse for wear, the error is identified, and steps are taken to reduce the likelihood of the error happening again. But concerning medication errors, the best-case scenario is often not the actual scenario. Medication errors frequently lead to significant harm to patients and are caused by systemic flaws that may not have simple solutions.

Statistics reveal the danger and frequency of medication errors:

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250k-400k

Deaths caused by medical errors per year

Statistic Icon

21%

Of adults have experienced a medical error

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$17.1 billion

The estimated annual cost of measurable medical errors that harmed patients in 2008

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1 in 7

Medicare patients experience a medical error in hospitals

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1 in 10

Doctors reported a major medical error prior to the survey

Nurse Graduate

49-53%

The percentage of medical errors that involve newly graduated registered nurses with less than a year of experience in patient care.

These figures demonstrate just how important it is for clinicians and organizations to prioritize medication management. This e-book is designed to help you develop a new medication management program or improve an existing program. It includes guidance on an extensive range of medication management-related matters and provides valuable tips and tools that can elevate the performance of any medication management program. When a medication management program is firing on all cylinders, the benefits are evident and significant, including reduced readmissions and medical costs, increased patient safety, and greater achievement of health goals. Leverage the resources in this e-book as part of your ongoing efforts to enhance the overall delivery of care for your patients. Even the smallest of improvements is likely to have wide-reaching, positive effects.

What is Medication Management?
1. What is Medication Management?

There’s no question that medications are incredibly important for treating patients with acute and chronic conditions. However, with approximately 50% of patients taking medications incorrectly, it’s vital that hospitals and clinicians consistently follow best practices. This helps ensure patients take their medications the right way so their health can improve or, at the very least, they can better manage their condition.

Medication management is a service to help patients manage their medications so they take them as prescribed, and avoid the adverse effects associated with incorrect medication administration.

Some best medication management practices to consider implementing in your facility include the following:

  • Perform medication reconciliation at every patient encounter
  • Engage patients
  • Ensure comprehensive discharge planning
  • Schedule a prompt follow-up visit to reconcile and discuss medications and regimen changes
  • Proactively follow up with high-risk patients
  • Use motivational interviewing and other communication techniques
  • Update guidelines for prescribing opioids to reflect current recommendations

Medication Adherence

A critical aspect of successful medication management is medication adherence. If patients are failing to take their medication as directed, one could argue that the medication management process loses significant value.

To help clinicians put their patients in the best possible position for successful adherence, here are a few tips you should follow:

  • Provide education and training on adherence
  • Give resources to support adherence efforts
  • Allocate time for patient engagement
  • Require documentation of adherence discussions
  • Invest in helpful technology

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Importance of Patient Education and Adherence
2. Importance of Patient Education and Adherence

Importance of Medication Education

Statistics show that every minute, around three Americans call a poison control center because they’ve made a mistake with their medication. Patient education is vital to reduce the frequency of these errors.

There are a few key areas clinicians should focus on when sharing vital information about medications:

  • Medication's purpose
  • Desired effects and possible side effects
  • Medication name and qualities (e.g., type, color, shape)
  • Instructions for proper use
  • Warnings
  • Responding to side effects
  • Importance of asking questions
  • Value of transparency concerning medication history

Furthermore, make sure patients understand the crucial role they play in their own care. While education is of the utmost importance, if a patient doesn’t understand how to put that knowledge into action, your efforts will to help them will likely come up short.


Patient Medication Management

Clinicians help patients in a number of ways, including diagnosing conditions, providing treatments, recommending services, and prescribing medications. However, clinicians can only do so much when it comes to the action that patients actually take, which is the case with medication management.

To support patients, clinicians can positively influence decisions with patient medication management. A few reasons patients often struggle with adherence include:

Low health literacy
This is the capacity for individuals to obtain, process, and understand the basic health information and services required to make proper health decisions. Clinicians should be prepared to assess their patients' health literacy and support patients with lower literacy using different resources, when applicable.

Cost
Believe it or not, cost is most common reason prescriptions go unfilled. Financial challenges often lead patients to delay or skip refilling medications or even rationing medication, which can prove dangerous. It’s for these reasons that clinicians should discuss finances with their patients and provide information about how patients can obtain financial assistance, order medications by mail, and take other steps to aid in patients obtaining and affording the medications they need.

Misunderstanding
Another reason patients often struggle with adherence is lack of understanding of their prescriptions. This may include the purpose of medication, why it’s necessary, side effects, and how long the medication takes to work. Clinicians must take the time to discuss each medication and the medication’s qualities with patients.

Fear
Finally, fear of side effects may also prevent patients from taking or even filling their prescriptions. Clinicians can work to prevent these adherence obstacles by discussing all side effects with patients and any concerns patients may have with following their medication regimen.


Medication Management Activities

Taking education and adherence one step farther, there are medication management activities that can support your efforts to help patients stick with their medication regimen.

  1. Ask patients to bring all of their medications with them to each appointment or at least bring a detailed list of their medications, including name, dosage, and regimen. Taking photos of the prescription labels using a smartphone may be useful.

  2. When reminding patients about appointments, also remind them to bring their medications or a list or photos, as detailed above.

  3. Provide patients a current medication list at the end of each visit.

  4. Explain the benefits of pharmacy “pill packs,” and provide a list of service providers.

  5. Suggest that patients use an automated, pill reminder app.

  6. Encourage patients to use a medication synchronization service.

  7. Distribute and display a medication fact sheet in the office.

  8. Improve staff training and provide guidance to all staff about how to speak with patients and families about the importance of taking medicines as prescribed.

Medication Management for Seniors

Finally, we can’t move on from this section until we address an important — and particularly vulnerable segment of patients: seniors. Adults 65 and older are at greater risk for medication-related problems. Three main reasons: 1) they are more likely to take multiple medications; 2) they’re more susceptible to side effects and (3 they are at a higher risk of drug interactions.

While the best practices we’ve already covered can apply to this age group, there are a few additional steps clinicians can take to improve success concerning medication management for seniors.

Focus on education
Before even discussing a medication, clinicians should ensure that patients can properly manage their medication regimen. This might require addressing obstacles such as poor health literacy, declining memory and eyesight, language barriers, and financial stability. Once you’ve determined if there are any potential obstacles, review information such as the medication’s purpose, how the medication should be taken, possible side effects, and other key details.

Make it a priority to discuss cost
Cost is increasingly becoming a medication adherence barrier for seniors. The top 20 brand-name drugs most commonly prescribed for seniors from 2012 to 2017 have increased in price. Since many seniors live on a tight budget and fixed income, affordability of prescriptions may hinder medication adherence.

Reduce complexity
Seniors also tend to take more medications, which increases the complexity of their regimen. When possible, reduce the number of medications and their administration frequency.

Provide and recommend resources
While verbal instructions can prove helpful, this type of communication also leaves room for error. As much as possible, clinicians should provide patients with a written list of all current medications and their accompanying information, in addition to other resources that can aid in adherence.

Leverage technology
While not all seniors will be comfortable with or even use smart technology, clinicians should take advantage of those that do. A 2018 Pew Research Center survey showed that nearly half of U.S. adults 65-plus years of age owned a smartphone, so there is an opportunity to effectively leverage this technology comfort level. If your patient is tech-savvy, recommend a medication adherence app that can improve their medication management.

Conduct regular medication reviews
Finally, make sure to regularly review senior patients' medications. As a patient's conditions change, a medication prescribed in the past might not be the best option even just a few months later.

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Medication Management in Hospitals3. Safety in Hospitals

Medication management presents a number of challenges in a hospital setting that can contribute to readmissions. However, when steps are taken to improve the medication management process, hospitals can ultimately reduce medication related readmissions. There are many complexities to consider and overcome in order to accomplish this important objective. Let’s explore a few major challenges.

Patient Financial Constraints
One in four Americans report difficulty affording their prescription drugs, and one in eight say that they or a family member have rationed doses due to high costs. So, for many patients, you must be aware of how cost could affect their ability to even fill a prescription, let alone take it correctly.

Medication Costs
Not only do patients struggle with medication costs, hospitals do as well. Rising costs are straining hospital budgets, leading some hospitals to pursue alternative medication therapies to better control costs. Such financial stress can prevent hospitals from making the best clinical decisions and providing the highest quality of care.

Drug Shortages
Approximately 80% of hospitals reported that medication shortages were an issue for them. Such shortages, which can also contribute to rising medication costs, may require hospitals to make difficult medication-related decisions, such as finding substitute medications, conserving supplies, producing their own medications in a compounding pharmacy, and determining which patients need medication right away and which patients can safely have treatment delayed.

Safety Risks
Medication errors that occur in hospitals present safety risks for patients. While not all mistakes cause harm, many can lead to injury or even death. The challenge is that there are so many factors that can cause a medication error, making it difficult to determine the best ways to prevent mistakes.

Incomplete Patient Medication Histories
To provide the best medication management, clinicians must have access to a patient’s comprehensive medication history. If even one detail of a patient’s medication history is omitted, this could lead to an adverse event.

Care Transition Breakdowns
With every transition between doctors, departments, or facilities, there’s potential for a breakdown to occur. For example, a breakdown can occur if a patient has limited English proficiency or low health literacy and does not follow their treatment plan correctly or a patient or caregiver is excluded from transition planning.

Opioid Prescribing
A newer challenge that has emerged in recent years concerns prescribing opioids. This issue requires clinicians to carefully differentiate which patients are showing drug-seeking behavior, which are planning to sell the drugs, and those that actually require an opioid prescription.


Importance of Medication Safety

To help keep patients safe from the challenges noted above, there are several steps organizations can take to protect patients from errors:

  1. Be consistent about medication reconciliation

  2. Encourage patients to participate in medication reconciliation

  3. Ask granular questions about over-the-counter medicines and supplements

  4. Make drug references tools handy for clinical teams

  5. Engage pharmacists

  6. Follow up with patients after discharge and office visits

  7. Encourage older patients to bring an advocate

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Medication Management
4. Importance of Medication Administration, Drug Interactions, and Opioid Pain Management

Importance of Medication Administration

Another key aspect of medication management is ensuring that medications are administered safely and accurately. Evidenced by the fact that the median error rate of medication administration is 8%-25%, consider ways you can improve medication administration in your facility.

  1. Assess the work environment
    Mistakes and other safety issues can increase due to certain work conditions. These include staff shortages or turnover, staff distractions or interruptions, poorly designed medication safety protocols, and failure by staff to adhere to policies and guidelines. It is vital to evaluate each of these areas mentioned on a regular basis and make changes as needed.

  2. Implement medication safety technologies
    There are a number of technologies that can improve medication safety, including medication safety alerts, medication and patient barcoding, smart infusion pumps for intravenous (IV) administration, and single-use medication packages. While technology can prove helpful, effective use requires careful oversight and training.

  3. Educate patients and caregivers
    Since many medication administration problems occur due to patient or caregiver error, this is an area providers cannot afford to ignore. Provide patients and/or caregivers with the necessary education, including how to properly take medications at home and when to contact their provider if they aren’t sure about how to administer it or have other questions concerning a medication.

  4. Implement strategies for “LASA” drugs
    When patients are prescribed a look-alike and/or sound-alike (LASA) drug, there is major potential for an error to occur. This can happen whether the names, packaging, or administration device are similar. Fortunately, there are a few ways that clinicians can work to avoid errors due to LASA drugs, including the following:

    • Use “tall-man lettering
    • Add warning labels to alert staff
    • Educate patients and caregivers about these types of drugs
    • Configure your computerized order entry system to alert clinicians when they are prescribing a LASA drug

  5. Take extra precaution with “high-alert” medications
    Finally, take additional precaution when it comes to medications that are more likely to cause harm or death when used in error. According to the Institute for Safe Medication Practices (ISMP), the top five high-alert medications are insulin, opiates and narcotics, injectable potassium chloride (or phosphate) concentrate, IV anticoagulants (heparin), and sodium chloride solutions above 0.9%.

Importance of Drug Interactions

As mentioned in the previous section, educating patients and caregivers can help prevent medication errors. Discuss each of these areas related to drug interactions with your patients and caregivers:

  • Drug interaction risks 
  • Types of drug interaction risks
  • Patient-specific risks
  • Medication labels
  • Supplements
  • Responding to a drug interaction

Opioid Pain Management

One specific area of medication management that should not be overlooked is opioid pain management. As a serious problem on the rise, opioids claimed more than 64,000 lives in 2017 and data show an almost fourfold increase in overdose deaths from 1999 to 2008.

While healthcare providers should be aware of opioid-related dangers, there are many patients who still require this opioids to effectively manage their pain.

Here are a few initiatives the healthcare industry is undertaking to better manage opioid pain management:

  1. CMS Roadmap
    The Centers for Medicare & Medicaid Services (CMS) recently took an official stance on the opioid crisis and published a piece to address three key components: prevention, treatment, and data.

  2. Organizations review and update prescribing guidelines
    Many healthcare organizations are reviewing and updating guidelines for managing acute and chronic pain, which includes using technology to alert clinicians about risk issues and prescribing behavior. For example, Kaiser Permanente Southern California, began working to reduce the inappropriate use of opioids in 2010.

    A few steps the organization took were creating restrictions, implementing monitoring technology and providing clinicians with guidance for prescribing and formulary policies. The organization has reduced its prescribing of the highest-risk, long-acting opioid medications for non-cancer, non-hospice patients by more than 72% and high-volume prescriptions of short-acting opioids by 98%.

  3. Training courses focused on best practices and alternatives
    In 2017, An estimated 11.4 million people misused prescription opioids—putting them at risk for dependence and addiction. Organizations must train clinicians with methods and tactics that can prevent additional medication therapy-related risks and medication abuse for patients.

  4. Prescription drug monitoring programs (PDMPs)
    PDMPs are valuable tools. State-based electronic databases, they track the prescribing and dispensing of controlled substances. With 49 states and the District of Columbia using PDMPs, these systems have effectively contributed to the reduction in opioid prescriptions by 8% and prescription opioid overdose death rates by 12%.

  5. New technologies for improving medication history
    Knowing a patient’s medication history is a crucial part of opioid pain management. However, this information is not always easy to obtain from patients or other healthcare organizations. A technology platform such as Meds 360° allows clinicians to current medication lists in real time, providing an accurate view of any potential risks related to opioids.

  6. Forming of coalitions
    Finally, healthcare organizations are recognizing the need to work together with county health departments, providers, payors, and community groups toward the common goal of addressing prescription drug abuse within the community, which is leading to the formation of collaborative coalitions

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Medication Management Process
5. Developing an Effective Medication Management Process

Medication Management Care Plan

A successful medication management care plan hinges upon collaboration with the patient. Here are some steps you can take to improve the care plan's effectiveness.

  1. Perform a drug inventory — A trained clinical staff member should conduct a review of each prescription, over-the-counter medicine, vitamin, and herbal remedy with the patient. For each medication, this staff member should document the name, reason for taking, dosage, frequency, correct time to take it, and any special instructions.

  2. Assess effectiveness, adherence, safety, and cost — Once the inventory is complete, a physician, mid-level provider, or registered nurse should speak with the patient about any reasons they may have for not taking medications and potential obstacles to adherence, such as cost.

  3. Discuss at-home medication organization — Discuss how a patient is keeping prescriptions organized at home. This is particularly important for patients with limited dexterity, cognitive impairment, or mobility issues. Discussion topics may include asking patients if they have a pill tray, how they remember which pill goes in each section, and if anyone double checks the filled pill tray.

  4. Help the patient create or refine the medication regimen — Since creating an effective medication regimen can be challenging, address any issues patients might have with their routine. For example, if a patient routinely forgets to take pills, ask why. Reasons might include leaving the home without medications or falling asleep before their final dosage of the day.

  5. Encourage the use of individualized, multi-dose drug dispensing (MDD) — For patients that struggle to remember if they took their medication or are unsure which medications to take, the use of MDD may be a good option. Some pharmacies can dispense a MDD pack that includes all the patient’s daily medicines in tear strip bags or bubble packs as opposed to single prescription bottles.

Medication Management Services

As you prioritize improving medication management in your organization, you can help patients with adherence by offering these services.

Medication Therapy Review
This is defined by the American Pharmacists Association as the:

“Systematic process of collecting patient-specific information, assessing medication therapies to identify medication-related problems, developing a prioritized list of medication-related problems, and creating a plan to resolve them.”
This review not only sets a solid foundation for future success with medication management, it also allows you to make appropriate medication decisions for patients and provides the most effective guidance. 

Comprehensive Medication Analysis
To assemble a comprehensive understanding of a patient’s medications, there is a lot of information to digest, including the names of medications, what they do, when they are taken, and side effects. Beyond this, there may also be non-prescription medications, herbals, supplements, and vitamins to consider.

A thorough, face-to-face discussion with the patient is critical for reviewing all medications, answering questions, and discussing potential ways to improve management, such as using a written medication plan, pill organizer, and/or mobile app.

New Medication Education
One of reasons patients do not take new medications is “misunderstanding.” It’s for this reason that you must take the time to discuss with the patient the new prescription, explain why it’s important, the roles the drug plays in overall care, instructions, side effects, and any questions.

Identify and Recommend Generics
If you identify and prescribe a generic medication, make sure your patient is aware so they can ensure that the correct medication is filled at the pharmacy. Prescribing a generic can help ease the financial barrier to filling and taking their medication as prescribed.

A few ways for clinicians to identify if a generic version of a medication exists include the following:

Provide Education on Pharmacy Services
Finally, services offered by pharmacies can offer an addition means of supporting patients with medication management and adherence. A few helpful services that may be available include:

  • Text alerts and refill reminders
  • Automatic refill
  • Medication synchronization to align prescription fill dates
  • Shipping of prescriptions
  • Rewards system (a gamification technique)
  • Mobile apps that can help with arranging pickup, payment, and prescription renewals

Medication Management Goals

Whether you’re working to evaluate your medication management process or building a process from scratch, it’s helpful to establish goals to serve as guidelines. Here are some worth considering.

1

Improve Patient Education — Patients fail to follow medication regimens for many reasons, including fear, misunderstanding, cost, and worry. Each of these problems can be solved by improving patient education.

Doing so might require assessing your organization’s current approach to education and its effectiveness. Education should cover any potential areas that could prevent patients from following their medication plan, including side effects, cost challenges, obstacles to filling or refilling prescriptions, and failing to follow a schedule, as well as steps to take if they have questions or concerns about their medication.

Patient Education for Medication Management
2

Reduce Medication Errors — While every organization should set a goal of zero medication errors, it may be more reasonable to start by setting achievable goals to reduce the number of medication errors each month, quarter, and year.

To help reach your goals, perform a comprehensive root cause analysis when a medication error and adverse drug event occurs. Using the results from this analysis, you can determine changes that need to be made and measure if the changes you make are preventing medication errors from occurring.

Reduce Medication Errors
3

Strengthen Follow-Up Processes — Set a goal for a follow-up plan whenever a patient leaves a hospital or doctor’s office. This will ideally be in the form of a follow-up appointment with a primary care practitioner (PCP). One study showed that “patients lacking timely PCP follow‐up were 10 times more likely to be readmitted for the same condition within 30 days of hospital discharge and nearly seven times as likely to be readmitted for the same condition or receive other care.”

This appointment can ultimately serve to:

  • Review medication regimen
  • Catch signs indicative of non-adherence
  • Provide education
  • Answer patient questions
Strengthen Medication Follow-Up

Medication Management Goals

Now that we’ve covered how to put together a plan, medication management services, and goals for your organization, what’s left is improving the medication management process as a whole. Here are a few tips for improving various elements of the process.

  1. Put a pharmacist in charge

  2. Ensure patients have ample access to a pharmacist or pharmacy students

  3. Educate patients about common medication mistakes

  4. Check the American Geriatrics Society's Beers list

  5. Deprescribe unnecessary medications, when possible

  6. Watch for the “prescription cascade”

  7. Suggest reminder and organization tools that are most comfortable for patients

  8. Talk about adherence at every visit

Medication Management Systems

Another key component of process success hinges upon the software system you use to support medication management. Since there are many options out there, here are a few worthwhile qualities to look for when researching software choices.

  1. Intuitive — Adopting a new system can be a challenge in and of itself. For this reason, choosing an intuitive system can make the transition easier for everyone required to use the solution. An intuitive design should include the ability for users to easily understand the system's core functions and features and controls. When evaluating software solutions, engage clinical end-users to determine if the systems are easy for them to understand and use.

  2. Comprehensive and current — When you’re able to view a complete list of medications, which might include prescription, non-prescription, alternative, traditional, vitamins, and nutritional supplements, management becomes easier and better supports adherence.

  3. Insightful — A good medication management system will also provide insights that help keep a patient safe. For example, a system should warn clinicians when there might be a hazardous drug combination, medication duplication, or risky dosage.

  4. Mobile-friendly — With clinicians frequently on the go, they should be able to easily access the system using their preferred smart device.

  5. Secure — Any system that stores sensitive patient information must be HIPAA-compliant and secure to help avoid the potential risk of a data breach.

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Medical Staff Training for Medication Management
6. Staff Training, Tips, and Tools

Safe Medication Management

Just as crucial as the software you have in place is ensuring that you train staff in safe medication management. Here are a few guidelines to follow:

  1. Be on alert for high-alert medications — High-alert medications are defined by the Institute for Safe Medication Practices (ISMP) as:
    “Drugs that bear a heightened risk of causing significant patient harm when they are used in error. Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly more devastating to patients.”
    While ISMP provides a standard list of these medications, it’s a good idea to revise the list according to the medications your facility frequently uses. With this list, you can train staff about the dangers of these drugs and also teach them how to most effectively educate patients about these medications.

  2. Watch out for look-alike/sound-alike (LASA) medications — For medications with similar appearances or names, training your staff on these medications can help save lives. By maintaining a list of these medications and educating staff about them, you can reduce potential errors by:

    • Avoiding the use of abbreviations
    • Using tall-man lettering to help distinguish medications
    • Limiting access to these medications
    • Using warning flags in computer systems
    • Storing LASA medications in different locations

  3. Don’t cut corners on storage — The physical storage of medications is another important aspect to consider. This includes security, safety, safe handling, integrity, and distribution. To avoid issues related to these areas, organizations should make sure that storage rules are detailed and staff are trained to follow each of the instructions. Tips for proper storage include:

    • Develop policies for all aspects of storage
    • Use standardized order sets
    • Decrease availability of floor-stock medications
    • Restrict access to high-alert medications
    • Follow manufacturers' instructions for storing medications
    • Encourage staff reporting of storage errors; use reports as learning and teaching opportunities.
    • Focus on the emergency department as it is often busy and fast paced

  4. Maintain ongoing monitoring of medications — Ongoing monitoring can also prevent potential safety risks with medication management. Every organization should have a system and schedule in place that can identify potential safety risks, such as:

    • Expired medications
    • Medications passed their beyond-use dates
    • Low stock
    • Inadequate storage space
    • Poor organization
    • Compromised security
    • Compromised medication integrity
    • Poor labeling
    • No distinct separation of LASA drugs
    • Mixing of controlled substances, high-alert drugs, vaccines, and samples with other medications


Medication Management Tips

Improved medication management ensures that patients receive the maximum benefits from their prescriptions and organizations not only reduce admissions, but also increase savings.

Here are a few tips for providers to help patients with medication management:

  1. Understand obstacles to effective management

  2. Assess the individual needs of each patient

  3. Be prepared with resources

  4. Follow up with patients

Medication Management Tools

While training your staff and following best practices for medication management, it’s also helpful to put tools in place to support your organization’s efforts. Consider these medication management tools:

1

Electronic prescribing of controlled substances — The use of e-prescribing for controlled substances can enhance patient safety. E-prescribing can help clinicians identify potential issues, such as duplicate therapies, interactions, and allergies; prevent mistakes associated with sound-alike drugs; and improve adherence.

Electronic Prescribing of Controlled Substance
2

Bar-coded medication administration (BCMA) systems — BCMA systems allow users to electronically document medications at the point of care. Using a handheld device, clinicians scan the barcode on their identification badge, the patient's wristband, and the medication package. This allows the system to determine whether the medication scanned is correct for the patient.

BCMA System
3

Medication safety self-assessment for hospitals — This tool allows organizations to assess the safety of medication practices in their facilities and identify areas for improvement.

Hospital Medication Safety Assessment
4

Medication reconciliation solutions — Finally, seek out a medication reconciliation tool that provides all physicians, nurses, and pharmacists with access to a complete list of a patient’s medications. Meds 360° is a solution that provides a clear medication history, allowing clinicians to make better management decisions.

Medication Reconciliation Solution

Conclusion

Within this e-book, we have provided you with numerous best practices and resources. Some will be easy to implement and integrate. Others will require more work and substantial coordination between various stakeholders. But all can help you develop the foundation for a successful medication management program or take your current program to higher levels of safety and effectiveness.

As you set out to build or strengthen your program, perform continuous monitoring and evaluation. This will help ensure that the policies and processes you implement achieve their desired results. This should also help you identify problems and inefficiencies that can be fixed and opportunities for positive changes. Engage all stakeholders — including patients and their caregivers, where applicable — for feedback on your efforts and suggestions for improvement. Even the best medication management programs have room for growth.

Finally, and perhaps most important, is to learn from every single medication error made within your organization. Mistakes happen; that is a given. What isn't is that similar mistakes must happen again and again. That's where the importance of a non-punitive culture comes in. With such a culture, team members are encouraged to acknowledge and raise awareness of errors, including their own. In most cases, rather than face punishment for making a mistake, staff are empowered to help with assessing the error and determining its root cause(s). Staff are further engaged to support efforts to strengthen systems and processes to best ensure that the same error is not repeated — by themselves or any other member of the team.

When an organization strives to learn from its shortcomings and places an emphasis on accountability and process improvement, its programs — including medication management — grow stronger by the day. And that means patient care will as well.

Medication Management for Clinicians

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