Implementation and sustainability of a medication reconciliation toolkit: A mixed methods evaluation.
Purpose MARQUIS (Multi-Center Medication Reconciliation Quality Improvement Study) provided participating hospitals with a toolkit to assist in developing robust medication reconciliation programs. Here we describe hospitals' implementation of the MARQUIS toolkit, barriers and facilitators, and impo...
| Publicado en: | American Journal of Health-System Pharmacy Vol. 77; no. 14; pp. 1135 - 1144 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
7/15/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144460689&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 144460689 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10792082 1X3 jtl: American Journal of Health-System Pharmacy issn: 10792082 maglogo: N pubinfo: dt: 7/15/2020 vid: 77 iid: 14 pid: 622 pub: Oxford University Press / USA artinfo: ui: 144460689 144460689 144460689 10.1093/ajhp/zxaa136 144460689 ppf: 1135 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Implementation and sustainability of a medication reconciliation toolkit: A mixed methods evaluation. aug: au: Stolldorf, Deonni P Mixon, Amanda S Auerbach, Andrew D Aylor, Amy R Shabbir, Hasan Schnipper, Jeff Kripalani, Sunil affil: Vanderbilt University School of Nursing , Nashville, TN sug: subj: Medication Reconciliation Transitional Care Quality Improvement Program Implementation Psychosocial Factors Human Multimethod Studies Quantitative Studies Qualitative Studies Surveys Interviews Descriptive Statistics Thematic Analysis Leadership Organizational Culture ab: Purpose MARQUIS (Multi-Center Medication Reconciliation Quality Improvement Study) provided participating hospitals with a toolkit to assist in developing robust medication reconciliation programs. Here we describe hospitals' implementation of the MARQUIS toolkit, barriers and facilitators, and important factors that may enhance the spread and sustainability of the toolkit. Methods We used a mixed methods, quantitative-qualitative study design. We invited site leaders of the 5 hospitals that participated in MARQUIS to complete a Web-based survey and phone interview. The Consolidated Framework for Implementation Research guided question development. We analyzed the collected data using descriptive statistics (for survey responses) and thematic content analysis (for interview results). Results Site leaders from each MARQUIS hospital participated. They reported that MARQUIS toolkit implementation augmented their hospitals' existing but limited medication reconciliation practices. Survey results indicated executive leadership support for toolkit implementation but limited institutional support for hiring staff (reported by 20% of respondents) and/or budgetary support for implementation (reported by 60% of respondents). Most participating hospitals (80%) shifted staff responsibilities to support medication reconciliation. Interview findings showed that inner setting (ie, organizational setting) and process factors (eg, designation of champions) both inhibited and facilitated implementation. Hospitals adopted a variety of toolkit interventions (eg, discharge medication counseling) using a range of implementation strategies, including development of educational tools and tip sheets for staff members and electronic health record templates. Conclusion Despite limited institutional support, hospitals can successfully implement, spread, and sustain the MARQUIS toolkit by shifting staff responsibilities, adding pharmacy staff, and using a variety of strategies to facilitate implementation. Although leadership support and resources for data collection and dissemination facilitated implementation, limited staff buy-in and competing priorities may hinder implementation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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