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Implementation strategies in the context of medication reconciliation: a qualitative study

BACKGROUND: Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional co...

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Autores principales: Stolldorf, Deonni P., Ridner, Sheila H., Vogus, Timothy J., Roumie, Christianne L., Schnipper, Jeffrey L., Dietrich, Mary S., Schlundt, David G., Kripalani, Sunil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193884/
https://www.ncbi.nlm.nih.gov/pubmed/34112265
http://dx.doi.org/10.1186/s43058-021-00162-5
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author Stolldorf, Deonni P.
Ridner, Sheila H.
Vogus, Timothy J.
Roumie, Christianne L.
Schnipper, Jeffrey L.
Dietrich, Mary S.
Schlundt, David G.
Kripalani, Sunil
author_facet Stolldorf, Deonni P.
Ridner, Sheila H.
Vogus, Timothy J.
Roumie, Christianne L.
Schnipper, Jeffrey L.
Dietrich, Mary S.
Schlundt, David G.
Kripalani, Sunil
author_sort Stolldorf, Deonni P.
collection PubMed
description BACKGROUND: Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. How to best implement MedRec interventions remains unclear. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, we report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit). METHODS: A qualitative study was conducted with implementation teams and executive leaders of hospitals participating in the federally funded “Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety” (known as MARQUIS2) research study. Data consisted of transcripts from web-based focus groups and individual interviews, as well as meeting minutes. Interview data were transcribed and analyzed using content analysis and the constant comparison technique. RESULTS: Data were collected from 16 hospitals using 2 focus groups, 3 group interviews, and 11 individual interviews, 10 sites’ meeting minutes, and an email interview of an executive. Major categories of implementation strategies predominantly mirrored the ERIC strategies of “Plan,” “Educate,” “Restructure,” and “Quality Management.” Participants rarely used the ERIC strategies of finance and attending to policy context. Two new non-ERIC categories of strategies emerged—“Integration” and “Professional roles and responsibilities.” Of the 73 specific strategies in the ERIC taxonomy, 32 were used to implement the MARQUIS Toolkit and 11 new, and non-ERIC strategies were identified (e.g., aligning with existing initiatives and professional roles and responsibilities). CONCLUSIONS: Complex interventions like the MARQUIS MedRec Toolkit can benefit from the ERIC taxonomy, but adaptations and new strategies (and even categories) are necessary to fully capture the range of approaches to implementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-021-00162-5.
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spelling pubmed-81938842021-06-15 Implementation strategies in the context of medication reconciliation: a qualitative study Stolldorf, Deonni P. Ridner, Sheila H. Vogus, Timothy J. Roumie, Christianne L. Schnipper, Jeffrey L. Dietrich, Mary S. Schlundt, David G. Kripalani, Sunil Implement Sci Commun Research BACKGROUND: Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. How to best implement MedRec interventions remains unclear. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, we report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit). METHODS: A qualitative study was conducted with implementation teams and executive leaders of hospitals participating in the federally funded “Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety” (known as MARQUIS2) research study. Data consisted of transcripts from web-based focus groups and individual interviews, as well as meeting minutes. Interview data were transcribed and analyzed using content analysis and the constant comparison technique. RESULTS: Data were collected from 16 hospitals using 2 focus groups, 3 group interviews, and 11 individual interviews, 10 sites’ meeting minutes, and an email interview of an executive. Major categories of implementation strategies predominantly mirrored the ERIC strategies of “Plan,” “Educate,” “Restructure,” and “Quality Management.” Participants rarely used the ERIC strategies of finance and attending to policy context. Two new non-ERIC categories of strategies emerged—“Integration” and “Professional roles and responsibilities.” Of the 73 specific strategies in the ERIC taxonomy, 32 were used to implement the MARQUIS Toolkit and 11 new, and non-ERIC strategies were identified (e.g., aligning with existing initiatives and professional roles and responsibilities). CONCLUSIONS: Complex interventions like the MARQUIS MedRec Toolkit can benefit from the ERIC taxonomy, but adaptations and new strategies (and even categories) are necessary to fully capture the range of approaches to implementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-021-00162-5. BioMed Central 2021-06-10 /pmc/articles/PMC8193884/ /pubmed/34112265 http://dx.doi.org/10.1186/s43058-021-00162-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Stolldorf, Deonni P.
Ridner, Sheila H.
Vogus, Timothy J.
Roumie, Christianne L.
Schnipper, Jeffrey L.
Dietrich, Mary S.
Schlundt, David G.
Kripalani, Sunil
Implementation strategies in the context of medication reconciliation: a qualitative study
title Implementation strategies in the context of medication reconciliation: a qualitative study
title_full Implementation strategies in the context of medication reconciliation: a qualitative study
title_fullStr Implementation strategies in the context of medication reconciliation: a qualitative study
title_full_unstemmed Implementation strategies in the context of medication reconciliation: a qualitative study
title_short Implementation strategies in the context of medication reconciliation: a qualitative study
title_sort implementation strategies in the context of medication reconciliation: a qualitative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193884/
https://www.ncbi.nlm.nih.gov/pubmed/34112265
http://dx.doi.org/10.1186/s43058-021-00162-5
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