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Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation

BACKGROUND: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolki...

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Autores principales: Mixon, Amanda S., Smith, G. Randy, Mallouk, Meghan, Nieva, Harry Reyes, Kripalani, Sunil, Rennke, Stephanie, Chu, Eugene, Sridharan, Anirudh, Dalal, Anuj, Mueller, Stephanie, Williams, Mark, Wetterneck, Tosha, Stein, Jason M., Stolldorf, Deonni, Howell, Eric, Orav, John, Labonville, Stephanie, Levin, Brian, Yoon, Catherine, Gresham, Marcus, Goldstein, Jenna, Platt, Sara, Nyenpan, Christopher, Schnipper, Jeffrey L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737715/
https://www.ncbi.nlm.nih.gov/pubmed/31511070
http://dx.doi.org/10.1186/s12913-019-4491-5
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author Mixon, Amanda S.
Smith, G. Randy
Mallouk, Meghan
Nieva, Harry Reyes
Kripalani, Sunil
Rennke, Stephanie
Chu, Eugene
Sridharan, Anirudh
Dalal, Anuj
Mueller, Stephanie
Williams, Mark
Wetterneck, Tosha
Stein, Jason M.
Stolldorf, Deonni
Howell, Eric
Orav, John
Labonville, Stephanie
Levin, Brian
Yoon, Catherine
Gresham, Marcus
Goldstein, Jenna
Platt, Sara
Nyenpan, Christopher
Schnipper, Jeffrey L.
author_facet Mixon, Amanda S.
Smith, G. Randy
Mallouk, Meghan
Nieva, Harry Reyes
Kripalani, Sunil
Rennke, Stephanie
Chu, Eugene
Sridharan, Anirudh
Dalal, Anuj
Mueller, Stephanie
Williams, Mark
Wetterneck, Tosha
Stein, Jason M.
Stolldorf, Deonni
Howell, Eric
Orav, John
Labonville, Stephanie
Levin, Brian
Yoon, Catherine
Gresham, Marcus
Goldstein, Jenna
Platt, Sara
Nyenpan, Christopher
Schnipper, Jeffrey L.
author_sort Mixon, Amanda S.
collection PubMed
description BACKGROUND: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. METHODS: MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site’s local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. DISCUSSION: A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.
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spelling pubmed-67377152019-09-16 Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation Mixon, Amanda S. Smith, G. Randy Mallouk, Meghan Nieva, Harry Reyes Kripalani, Sunil Rennke, Stephanie Chu, Eugene Sridharan, Anirudh Dalal, Anuj Mueller, Stephanie Williams, Mark Wetterneck, Tosha Stein, Jason M. Stolldorf, Deonni Howell, Eric Orav, John Labonville, Stephanie Levin, Brian Yoon, Catherine Gresham, Marcus Goldstein, Jenna Platt, Sara Nyenpan, Christopher Schnipper, Jeffrey L. BMC Health Serv Res Study Protocol BACKGROUND: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. METHODS: MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site’s local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. DISCUSSION: A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation. BioMed Central 2019-09-11 /pmc/articles/PMC6737715/ /pubmed/31511070 http://dx.doi.org/10.1186/s12913-019-4491-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Mixon, Amanda S.
Smith, G. Randy
Mallouk, Meghan
Nieva, Harry Reyes
Kripalani, Sunil
Rennke, Stephanie
Chu, Eugene
Sridharan, Anirudh
Dalal, Anuj
Mueller, Stephanie
Williams, Mark
Wetterneck, Tosha
Stein, Jason M.
Stolldorf, Deonni
Howell, Eric
Orav, John
Labonville, Stephanie
Levin, Brian
Yoon, Catherine
Gresham, Marcus
Goldstein, Jenna
Platt, Sara
Nyenpan, Christopher
Schnipper, Jeffrey L.
Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
title Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
title_full Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
title_fullStr Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
title_full_unstemmed Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
title_short Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
title_sort design of marquis2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737715/
https://www.ncbi.nlm.nih.gov/pubmed/31511070
http://dx.doi.org/10.1186/s12913-019-4491-5
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