National patient safety goals. Using consumer-based kiosk technology to improve and standardize medication reconciliation in a specialty care setting.

Background: Discrepancies in medication documentation most often occur at handoffs or transition points in care. A process improvement team at the Portland Department of Veterans Affairs developed a standardized medication reconciliation process for the Portland chemotherapy administration unit, a p...

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Publicado en:Joint Commission Journal on Quality & Patient Safety Vol. 35; no. 5; pp. 264 - 271
Autores principales: Lesselroth B, Adams S, Felder R, Dorr DA, Cauthers P, Church V, Douglas D
Formato: algorithm research tables/charts Journal Article
Publicado: Elsevier B.V. 2009 May
Acceso en línea:Ver este registro en EBSCOhost
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      vid: 35
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      pub: Elsevier B.V.
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        atl: National patient safety goals. Using consumer-based kiosk technology to improve and standardize medication reconciliation in a specialty care setting.
      aug:
        au:
          Lesselroth B
          Adams S
          Felder R
          Dorr DA
          Cauthers P
          Church V
          Douglas D
      sug:
        subj:
          Chemotherapy, Cancer
          Computers and Computerization Utilization
          Medication Reconciliation
          Academic Medical Centers
          Automation
          Communication
          Electronic Health Records
          Decision Making, Clinical
          Documentation
          Funding Source
          Interviews
          Oregon
          Patient Centered Care
          Patient History Taking
          Patient Safety
          Primary Health Care
          Professional-Patient Relations
          Quality Improvement
          Software
          United States Department of Veterans Affairs
          Human
      ab: Background: Discrepancies in medication documentation most often occur at handoffs or transition points in care. A process improvement team at the Portland Department of Veterans Affairs developed a standardized medication reconciliation process for the Portland chemotherapy administration unit, a physically self-contained clinic with a standard intake process and a uniform patient traffic pattern. Methods: The team developed the automated patient history intake device (APHID), a reconciliation software program accessed by the patient using a computer terminal kiosk in the clinic lobby. The program simultaneously checks in patients for an appointment and gathers a medication-adherence history by retrieving medication lists from all Veterans Affairs facilities and pairing each medication with a pill picture. Installation of the APHID kiosk included an initial two-week roll-in period beginning in February 2008. Results: During the roll-in period, 91 (82.0%) of 111 patients completed check-in and performed medication reconciliation using the kiosk. Medication lists gathered at the kiosk were compared with existing health record documentation and clinician interviews. For each patient encounter, the process demonstrated an average of 4.59 discrepancies and an average of 1.61 clinically significant or potentially lethal discrepancies. The new process saved approximately 0.24 full-time equivalents of nursing time in the chemotherapy clinicDLa nearly 50% reduction in nursing time dedicated to reconciliation activities without an apparent loss in data accuracy. Discussion: A patient-centered reconciliation model using consumer-based kiosk technology helped providers efficiently retrieve a comprehensive list of medications across a geographically diverse area and improve patient medication recall using visual cues including medication pictures.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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