a7 rapid fire: implementing medication reconciliation across the continuum - k. trapnell and f....

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Synergy for Success:Implementing Medication Reconciliation at

VCH-PHC

BC Patient Safety & Quality Council Quality Forum

March 2012Karin Trapnell

Fruzsina Pataky

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Overview

• Implementing MedRec on admission across a large complex health organization that spreads across rural and city centres presents with significant challenges

• To be successful requires a new world view of the organization and a strong leadership model in which leaders empower leaders with the support and the freedom to create a new path for change

Medication Medication ReconciliationReconciliationIt’s about the conversation.

3

VCH-PHC at a Glance • 22,000 staff• 556 locations• 13 acute care hospitals• 15 community health centres • 3+million patient days of care• Primary, secondary, tertiary

and quaternary services• Care, teaching, research• Affiliation with universities and

colleges• ≈80,000 admissions /yr

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Synergy for Success

Medication Medication ReconciliationReconciliationIt’s about the conversation.

• ……paradox of a living system… Each organism maintains a clear sense of its individual identity within a larger network of relationships that helps shape its identity. Each being is noticeable as a separate entity, yet it is simultaneously part of the whole system

Wheatley, M. (2006). Leadership and the New Science: Discovering Order in a Chaotic World

Synergy for Success

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Leadership Support

• Vancouver Coastal Health (VCH) and Providence Health Care (PHC) senior leadership team “walk the talk”

• Medication Reconciliation is an organizational strategic directive. “1.3 – To provide the best quality of care -Build a regional medication reconciliation system across the continuum.”

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Project Structure

• Regional Steering Committee • Executive Steering Committees (VCH & PHC) • TOR and Regional Project Charter

↓

Regional MedRec Leads Committee

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Project Structure

Medication Medication ReconciliationReconciliationIt’s about the conversation.

• The primary goal of the team leads has been to work together to create a regional approach to successfully implement MedRec

• The MedRec team leads created standardized tools and processes for implementation, education, communication, and evaluation to be utilized and adapted at local levels

Team Leads Committee

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Team Leads Committee

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Implementation Scope

Medication Medication ReconciliationReconciliationIt’s about the conversation.

• Implementation plan template• PharmaNet populated forms • Manual forms for all Communities of Care

(CoCs)• Forms for ambulatory care, residential care• Policy • Training module (ppt) • E module on CCRS • Webpage created • Medication safety pamphlet• Data coordination and reporting

Regional Supports

Medication Medication ReconciliationReconciliationIt’s about the conversation.

• The process for implementing MedRec forces us to connect in ways we haven’t before

• We’re getting to know and appreciate each other’s importance as part of a greater system

• We’ve come to understand the necessity of strengthening our relationships

• We realize to be successful - we need each other!

Learnings

Medication Medication ReconciliationReconciliationIt’s about the conversation.

• Progress

• Performance

• Outcome

Measures of Success

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Progress Measures – Residential Care

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Progress Measures – Acute Care

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Performance

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Outcome Measures

Medication Medication ReconciliationReconciliationIt’s about the conversation.

• Lindsay Bendickson - Clinical Resource Nurse, Professional Practice, Van Community• Renee Bjarnson – Pharmacist, Burnaby Centre for Mental Health & Addiction• Val Cartmel – Team Lead, Coastal Community of Care (to Jan 2012) • Jo Chang - Coordinator of Residential Pharmacy, UBCH - Koerner Pavilion • Chris Foley - Manager, Cambie Older Adult Mental Health Team.• Maylene Fong - Manager - AOA & PC, Evergreen CHC • Debra Halket - GNE, Pharmacy/Nursing PHC • Zoe Krickan - Supervisor - Patient Care Coordinator, Magnolia House• Nadine Lambert - Medication Safety Pharmacist and Medication Reconciliation Coordinator • Melissa Lo - VCH/PHC Regional Medication Safety Coordinator • Mary Marlow - Professional Practice Lead, Addiction Services • Grant McCullough - Practice Consultant, Professional Practice and Nursing• Naomi Monaster - AOA Clinical Applications Support Educator, IMITS - Community Applications • Shelley Novak - Medication Safety Pharmacist, Vancouver• Fruzsina Pataky - Regional Medication Safety Coordinator (to Nov. 11) • Nicola Piggott - Practice Initiatives Coordinator, Richmond MH & A,• Lisa Ramage - Manager - Mental Health & Addiction, Acute, Richmond• Mary Shyng - Medication Safety Pharmacist - Coastal • Jamie Simpson - Team Lead (Clinical) for IMITIS - Primary and Community Care• Karin Trapnell- Regional MedRec Project Manager-Professional Practice-Nursing • Harjender Walia - Clinical Educator Nursing, VA • Heather Wright - AOA Manager, Three Bridges CHC 

Medication Reconciliation Team Leads 2011-2012

Medication Medication ReconciliationReconciliationIt’s about the conversation.

Questions?