Outcomes of the Improvements of Medication Reconciliation Process by Multidisciplinary Health Team: Case Study at Internal Medicine Ward 1, Sawanpracharak Hospital, Nakhon Sawan Province

Abstract

Objective: To assess the outcomes of the improvements of medication reconciliation (MR) by the multi-disciplinary team of Sawanpracharak Hospital in terms of medication errors (ME) and saving on drug expenditures. Method: This descriptive study compared the outcomes of MR before and after the process improvement by clearly identifying the processes and those responsible leading to cooperation among multidisciplinary. The study was conducted in male internal medicine ward 1 of Sawanpracharak Hospital by collecting patient history and history on medication use from hospital information program (HosXP version 4) and MR form. Results: Patients. A total of 1,506 patients were aged 61-80 years with an average number of medications of 6 or more. The majority of history of patients’ drug use was obtained from two approaches including the search from hospital database and interviews of patients or relatives. Most patients had taken medications on regular basis, but 56.58% of patients brought their medications to hospital. The MR by multidisciplinary teams reduced the incidence of ME, especially prescribing error (PE). The first period of data collection showed the incidence of PE at 2.46 events per 1,000 patient-days. The incidence decreased in the latter part of the data collection with PE at 1.94 events per 1,000 patient-days. Omission error or not prescribing all medication the patients taking on regular basis decreased from the pre-improvement period (118 incidences in 3 months) to 86 incidences in the 3-month post-improvement period. The improvement of the process saved 42,930 baht of drug expenditures for patients and the hospital during the 6-month period of data collection. Conclusion: Improving MR by multidisciplinary team of the hospital by clearly stating the procedures and responsible persons helps reduce ME, especially PE, and medication expenditures.