Experiences from the implementation of structured patient discharge information for safe medication reconciliation at a Swedish university hospital

Författare

Tommy Eriksson
Peter Höglund
Lydia Holmdahl
Åsa ÅB Bondesson

Summary, in English

Study objectives:

A method for medication reconciliation that reduces medication errors and healthcare contacts when a patient is discharged from hospital, LIMM-DI (Lund integrated medicines management-discharge information) had been previously developed by the authors. LIMM-DI is structured information written for the patient and sent to the next caregiver. In this study, the use (implementation ratio) and errors when used were measured.

Methods:

During two three-week periods in 2008 and 2009 information on the use of LIMM-DI for every discharged patient at Skåne University Hospital in Lund, Sweden was collected. Medication errors and quality by chart reviews based on a previously developed checklist were also measured. The focus was placed on the medication report—which medications have been changed and why—and the medication list, two vital parts of LIMM-DI.

Results:

One hundred and thirty eight (27%) and 163 (31%) of the patients received LIMM-DI in periods 1 and 2, respectively. The mean number of errors per patient decreased from period 1 to 2 in the medication list (6.5 [standard deviation, SD, 6.0] versus 3.9 (SD, 4.2), p = 0.00098) but not in the medication report (5.3 [SD, 6.3] versus 5.3 [SD, 5.9], p = 0.99).

Conclusion:

Contrary to expectations, the implementation of LIMM-DI was slow and there was no great reduction in the number of medication errors. There is a need to improve the current strategy and to consider alternative strategies for

improving patient safety in the discharge medication reconciliation process.

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