Managing Medications for Improved Care Transitions

摘要: There are as many ways to lose track of patients' medications there care settings, but with proper communication and reporting, poor outcomes can be prevented. Care transitions refer patients being moved from one healthcare provider or setting another. This includes complex chronic illness, well those moving hospital home, nursing other community-based setting. Poorly executed may result in fragmentation, clinical outcomes, inappropriate use emergency department services, re-admission (Crotty et al., 2004). The impact transition errors on patient safety such re-admissions, is enormous has gained national attention, nearly five Medicare discharges re-admitted within thirty days, at a cost more than $26 billion per year (U.S. Department Health Human Services, 2011). Medication errors, communication, lack coordination the forefront problems attributed errors. Although individual factors contributing interplay between medications, continues present challenges providers (Boling, 2009). As individuals another, risk related increases, advance age, number illnesses resultant multiple increase. polypharmacy symptom burden illness also increase place high for adverse drug events outcomes. It often difficult determine was taking home when admitted hospital, up 46 percent admissions showing omitted established regimen without clear explanation (Cornish 2005). move setting, it common change, averaging three transition, increasing error (Forster 2003). And, discrepancies managing discharged have been documented 49 (Foust 2005; Moore 2003; Wong 2008). Adverse events, defined injury resulting medical management rather underlying disease processes, not uncommon first weeks discharge (up 19 percent) U.S. medication most factor these episodes, preventable (Coleman 2004; Boockvar An important part addressing problem understand which delivered, processes inherent across settings. information adequately capture evaluation studies, studies isolating selected process 2006). Despite fact that collaboration institutions central effective transitions, function isolation Berenson, In order effectively address errors-to reduce improve continuity-there must change thinking all disciplines. case scenarios we illustrate issues arise during long-term-care We'll then discuss strategies Case #1 (opposite), pharmacist said intravenous clindamycin received, because pharmacists involved, overlooked delivered. did receive two courses antibiotics, no harm suffered, he able return home. …