Canadian MedRec Quality Audit National Call

www.saferhealthcarenow.ca

Canadian MedRec Quality Audit National Call

October 1st, 2013


Welcome to our francophone attendees

Bienvenue à nos participants

francophones

Hélène Riverin Conseillère en sécurité et en amélioration

Safety Improvement Advisor


Overview

• Brief review of the MedRec quality audit tool

• Share the experience of two organizations who have used the audit tool

• Describe the Canadian MedRec Quality Audit Month

• Respond to Questions


Please complete our poll


Highlights of the MedRec Quality Audit Tool

Jennifer Turple


MedRec Quality Assessment DCF

6


June 2013 Webinar/National Call

Jennifer Turple

ISMP Canada

Alex Titeu

Safer Healthcare Now! Central Measurement

(Patient Safety Metrics)

http://www.saferhealthcarenow.ca/EN/events/NationalCalls/2013/Pages/A-Novel-Tool-to-Assess-the-Quality-of-Admission-MedRec-Processes.aspx

A Novel Tool to Assess the Quality of Admission MedRec Processes























Why focus on Admission?


Presence of an Admission MedRec /BPMH

form on chart

Are the processes “behind the form” of good quality?


How often are we doing everything as intended?


Selected Audit Tool Questions

• Was MedRec performed?

• Was the BPMH collected using more than 1 medication information source?

• Was there a patient or caregiver interview to verify actual medication use?

• Has every medication, as listed in the BPMH, been accounted for in the admission documentation? (i.e. are there any outstanding differences/discrepancies despite the MedRec process?)

• Where differences between the admission documentation and the BPMH exist, were these differences resolved?


MedRec Audit Experiences “from the field”

13

Béatrice Patton

Patient Safety Pharmacist

WRHA Quality and Patient Safety

Winnipeg Regional Health Authority

My Experience with

the MedRec Quality Audit Tool

October 1, 2013

Winnipeg Health Region Churchill Health Centre

http://www.sbgh.mb.ca/home.html

Current WRHA MedRec audit tools

Form #2

Overall quality

of completeness

Form #1

Compliance

Collating results

manually

Future WRHA MedRec audit tool

What is not to like?

ONE reporting form

Easy to use/complete

Simple to submit

Focuses on the QUALITY of

admission MedRec processes

Collated results available within

minutes in system!

Automated reports accessible to

sites/organization

The Raw Data

The Quality Measures

The Score

Expected results Actual results

60-80% compliance with MedRec admission form

100% of patients audited had a completed form in chart

All pre-admission patients interviewed for medication use

7/10 patients had a medication history taken with patient

At least 1 info source used (most commonly DPIN)

6/7 who had a pt interview, also had one other info source

Missing components in in medication information

Each medication was complete!

Not all meds reconciled (ie. decision box not checked off)

All meds were assessed/ reconciled!

>75 % rationale for holding 2/10 patients had a rationale provided

100% “reconciled”/completed at admission

only 1/10 met perfect QA score - deficiencies in process!

The Next Steps Plan for improvement: Pre-admission clinic:

Use one information source along with patient interview Indicate “unable to perform” on form when patients

unreliable/unable (need section on form)

Surgeons/HMOs Communicate importance of indicating rationale for

holding/discontinuing

Share and celebrate results with the orthopedic team: Great job in completing the MedRec admission form

(completeness of medication information, capturing information source, reconciliation)

Interior Health

Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia.

Interior Health Quality Audit

Med Rec

Geoff Schierbeck

Quality Consultant

Interior Health

[email protected]

Interior Health Authority

Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia



Is the BPMH based on greater than

1 source?


MedRec Quality Audit Month

• During the month of October, we are challenging all acute and long-term care organizations to audit their established processes for MedRec at admission.

• Auditing the process will help to identify areas of excellence and areas for improvements. Measurement is critical in the journey to improve the delivery of safe and effective care for patients.

• The purpose of the Canadian MedRec Audit Month is to

encourage acute care and long term care organizations to: • Qualify and quantify how they are performing the basics

tenets of the admission MedRec process, • Use the Canadian MedRec Audit data collection/audit tool

to inform admission MedRec process improvements, • Use Patient Safety Metrics System* to view and analyze

collated results.


October is MedRec Quality Audit Month!

Want to participate?

HERE’s HOW….


STEP

Determine your eligibility

to use this audit tool.

You should:

1- Have an implemented ADMISSION MedRec

process and

2- Have a MedRec process follows an Acute

Care OR Long Term Care model.


STEP

Consider which care areas you would like to audit and how you might wish to group/analyze the audit results.

For example, would you like to collect and analyze audit data from multiple units?, across multiple sites?, across a region?


MedRec Quality Assessment DCF

36


STEP

Register/Enroll to participate in Canadian MedRec Quality Audit Month.

Free to participate, by registering you are committing auditing your admission MedRec process during the

month of October.

https://secure.e-registernow.com/cgi-bin/mkpayment.cgi?MID=1527&state=step2direct&e

vent=500000274139982

https://secure.e-registernow.com/cgi-bin/mkpayment.cgi?MID=1527&state=step2direct&event=500000274139982







Registration

The information

entered here allows the

Patient Safety Metrics team to help build

your area specific data

collection forms/audit

tool


STEP

Access your audit tool

Either you can:

• Receive your audit tool from the Patient Safety Metrics team via email

OR

• Generate your tool yourself, via the Patient Safety Metrics System


Generating Audit Tool/Data Collection Form

1. Login into Patient Safety Metrics site: https://shn.med.utoronto.ca/metrics/Login.aspx

2. Select the Data tab 3. Select the Intervention for which you wish to add Either by selecting the intervention from the list or selecting the

intervention from the intervention tab 4. Click the Add new Data Collection Form button 5. Select the Survey from the drop-down menu, along with any

applicable attributes such as In/Out, Adult/Paediatrics, Age Group, Program, Service, Unit/Site, Procedure, or Patient Sample.

Please fill-out all as much information as possible. This will allow for better data roll-up and drill-down for reporting.

6. Click the Save button to add the new data collection form.

https://shn.med.utoronto.ca/metrics/Login.aspx


STEP

Choose a sampling approach

The number of charts you audit and the method you choose to select patients for auditing is

up to the end user.

We would suggest a minimum of 10-20 charts be audited, and that these charts be randomly selected.


STEP

Complete the audit

Follow the guidance for completion of the tool as provided on the June 18th, 2013 webinar:

http://www.saferhealthcarenow.ca/EN/events/NationalCalls/2013/Pages/A-Novel-Tool-to-Assess-the-

Quality-of-Admission-MedRec-Processes.aspx
























STEP

Submit your results (via fax) to the patient safety metrics system

Using a high resolution setting, fax your audit tool to the number found on bottom of the

audit tool


Questions?

44


3 ways to ask a question via Webex

45

All Participants

Under participants panel, raise your hand by clicking on the hand icon. If you have a phone icon beside your name we can unmute your line enabling you to ask your question “live”

Type your question in the chat box, select “all participants” from the drop down and click “send”

Type your question in the “Q & A” box


Key Contacts:

ISMP Canada MedRec Team

[email protected]

www.ismp-canada.org/medrec

CPSI Central Measurement Team

[email protected]

Virginia Flintoft - 416-946-8350

Alexandru Titeu - 416-946-3103

Key Links:

We are here to help!

Patient Safety Metrics System: https://shn.med.utoronto.ca/metrics/Login.aspx June 18th Audit Tool Call Slides/Recording: http://tinyurl.com/puxq8cj Registration Page for MedRec Audit Month: http://tinyurl.com/pox49bf

mailto:[email protected]



http://www.ismp-canada.org/medrec





https://shn.med.utoronto.ca/metrics/Login.aspx

http://tinyurl.com/puxq8cj

http://tinyurl.com/pox49bf


Please complete our poll


October 28th -November 1st, 2013.

October 30th Theme: Medication Safety: Across the Continuum Program Includes: •Implementing Med Rec Successfully. The New Paper to Electronic Toolkit 12:15 pm MT / 2:15 pm ET Dr. Andre Kushnirik, Professor, School of Health Information Science, University of Victoria; Adjunct Associate Professor, University of Toronto Faculty of Medicine and the Mt. Sinai School of Medicine, New York

•Engaging Consumers in Medication Safety: Results of three years of consumer error reporting program and planned plain language labeling project 11:00 am MT / 1:00 pm ET Lynn Riley, Medication Safety Specialist and Educator, Institute for Safe Medication Practices Canada (ISMP Canada)

•The Canadian MedRec Admission Quality Audit Results 12:40 pm MT / 2:40 pm ET Hugh McLeod, CEO, Canadian Patient Safety Institute

Full details available at: http://www.patientsafetyinstitute.ca/english/news/canadasforumpatientsafety/pages/default.aspx

http://www.patientsafetyinstitute.ca/english/news/canadasforumpatientsafety/pages/default.aspx

http://www.patientsafetyinstitute.ca/english/news/canadasforumpatientsafety/pages/default.aspx

Canadian MedRec Quality Audit National Call

Health & Medicine

Transcript of Canadian MedRec Quality Audit National Call