Journal article
Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
BMC health services research, Vol.19(1), 659
09/11/2019
DOI: 10.1186/s12913-019-4491-5
PMCID: PMC6737715
PMID: 31511070
Abstract
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.
Details
- Title: Subtitle
- Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation
- Creators
- Amanda S. Mixon - VA Tennessee Valley Healthcare SystemG. Randy Smith - Northwestern UniversityMeghan Mallouk - Society of Critical Care MedicineHarry Reyes Nieva - Brigham and Women's HospitalSunil Kripalani - Vanderbilt University Medical CenterStephanie Rennke - University of California San Francisco Medical CenterEugene Chu - Parkland Health & Hospital SystemAnirudh Sridharan - Howard County General HospitalAnuj Dalal - Brigham and Women's HospitalStephanie Mueller - Brigham and Women's HospitalMark Williams - University of KentuckyTosha Wetterneck - University of Wisconsin–MadisonJason M. Stein - 1Unit, Atlanta, GA USADeonni Stolldorf - Vanderbilt UniversityEric Howell - Johns Hopkins UniversityJohn Orav - Brigham and Women's HospitalStephanie Labonville - Brigham and Women's HospitalBrian Levin - Brigham and Women's HospitalCatherine Yoon - Brigham and Women's HospitalMarcus Gresham - Brigham and Women's HospitalJenna Goldstein - Center for Hospital Innovation and Improvement, Society of Hospital Medicine, Philadelphia, PA USASara Platt - Society of Critical Care MedicineChristopher Nyenpan - Society of Critical Care MedicineJeffrey L. Schnipper - Brigham and Women's HospitalMulti-center Medication Reconciliation Quality Improvement Study (MARQUIS2) Site Leaders
- Resource Type
- Journal article
- Publication Details
- BMC health services research, Vol.19(1), 659
- DOI
- 10.1186/s12913-019-4491-5
- PMID
- 31511070
- PMCID
- PMC6737715
- NLM abbreviation
- BMC Health Serv Res
- ISSN
- 1472-6963
- eISSN
- 1472-6963
- Publisher
- BioMed Central
- Grant note
- 12-168 / ; UL1 RR024975-01 / ; R18 HS023757; K01HS025486 / ; 2 UL1 TR000445-06 / ;
- Language
- English
- Date published
- 09/11/2019
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984772259702771
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