Gaps in continuity of medication management during the transition from hospital to residential care: An observational study (MedGap Study)

Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses;...

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Published in:	Australasian journal on ageing Vol. 31; no. 4; pp. 247 - 254
Main Authors:	Elliott, Rohan A, Tran, Tim, Taylor, Simone E, Harvey, Penelope A, Belfrage, Mary K, Jennings, Rhonda J, Marriott, Jennifer L
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-12-2012
Subjects:	Aged Aged care Aged, 80 and over continuity of patient care Continuity of Patient Care - organization & administration Drugs (Pharmaceuticals) Female Graphs Hospital discharge Hospitals Hospitals - standards Humans Male Management medication error Medication errors Medication Errors - prevention & control medication system Nursing homes Patient Discharge Patient Transfer - organization & administration Patients residential facility Residential Institutions Residential Treatment - organization & administration Retrospective Studies
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Abstract	Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies. Results: Seventy‐five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty‐five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety‐seven of 392 (50.3%) changes to regularly scheduled medications were communicated. Conclusions: Strategies are needed to address gaps in the continuity of medication management.
AbstractList	To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies. Seventy-five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty-five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety-seven of 392 (50.3%) changes to regularly scheduled medications were communicated. Strategies are needed to address gaps in the continuity of medication management. Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies. Results: Seventy‐five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty‐five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety‐seven of 392 (50.3%) changes to regularly scheduled medications were communicated. Conclusions: Strategies are needed to address gaps in the continuity of medication management. Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies. Results: Seventy‐five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty‐five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety‐seven of 392 (50.3%) changes to regularly scheduled medications were communicated. Conclusions: Strategies are needed to address gaps in the continuity of medication management. Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies. Results: Seventy-five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty-five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety-seven of 392 (50.3%) changes to regularly scheduled medications were communicated. Conclusions: Strategies are needed to address gaps in the continuity of medication management. Adapted from the source document. AIMTo assess continuity of medication management during transition from hospital to residential care facilities (RCFs).METHODTelephone interviews with RCF staff were performed 24 hours after patient transfer to determine the proportion of patients with: missed or significantly delayed doses; RCF medication chart not written/updated in time for the first dose; suitably packed medications not available for the first dose; and RCF medication chart written/updated by a locum doctor. Retrospective audit was used to identify discharge summary discrepancies.RESULTSSeventy-five doses for 37/202 (18.3%) patients were missed or significantly delayed in the 24 hours after discharge. One hundred and twenty-five (61.9%) patients did not have their medication chart written/updated and 77 (38.1%) did not have suitably packed medications available for the first dose. Locum doctors wrote RCF medication charts for 66 (32.7%) patients. One hundred and ninety-seven of 392 (50.3%) changes to regularly scheduled medications were communicated.CONCLUSIONSStrategies are needed to address gaps in the continuity of medication management.
Author	Marriott, Jennifer L Elliott, Rohan A Harvey, Penelope A Jennings, Rhonda J Belfrage, Mary K Taylor, Simone E Tran, Tim
Author_xml	– sequence: 1 givenname: Rohan A surname: Elliott fullname: Elliott, Rohan A email: rohan.elliott@austin.org.au organization: Pharmacy Department, Austin Health; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia – sequence: 2 givenname: Tim surname: Tran fullname: Tran, Tim organization: Pharmacy Department, Austin Health, Melbourne, Victoria, Australia – sequence: 3 givenname: Simone E surname: Taylor fullname: Taylor, Simone E organization: Pharmacy Department, Austin Health, Melbourne, Victoria, Australia – sequence: 4 givenname: Penelope A surname: Harvey fullname: Harvey, Penelope A organization: Bundoora Extended Care Centre, Melbourne, Victoria, Australia – sequence: 5 givenname: Mary K surname: Belfrage fullname: Belfrage, Mary K organization: North East Valley Division of General Practice, Heidelberg Repatriation Hospital, Melbourne, Victoria, Australia – sequence: 6 givenname: Rhonda J surname: Jennings fullname: Jennings, Rhonda J organization: Bundoora Extended Care Centre, Melbourne, Victoria, Australia – sequence: 7 givenname: Jennifer L surname: Marriott fullname: Marriott, Jennifer L organization: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/23252983$$D View this record in MEDLINE/PubMed
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Cites_doi	10.1136/qshc.2006.020842 10.1001/archinte.164.5.545 10.1046/j.1440-1762.2001.00430.x 10.1002/j.2055-2335.2009.tb00432.x 10.1046/j.1532-5415.2003.51185.x 10.1016/j.amjopharm.2008.10.001 10.1002/j.2055-2335.2009.tb00456.x 10.1136/bmj.311.7001.376 10.1016/j.amjopharm.2005.01.001 10.1002/j.2055-2335.2007.tb00752.x 10.1111/j.1741-6612.2009.00376.x 10.2165/00002512-200320090-00002 10.1016/j.ijmedinf.2009.09.002 10.1007/s11606-009-0948-2 10.1001/jama.297.8.831 10.1016/j.amjopharm.2006.09.003
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Results of a randomized, controlled trial publication-title: The American Journal of Geriatric Pharmacotherapy – year: 1999 – volume: 9 start-page: 1090 year: 2009 ident: e_1_2_6_5_2 article-title: An investigation of medication information transfer and application in aged care facilities in an Australian rural setting publication-title: Rural and Remote Health contributor: fullname: Pierce D – ident: e_1_2_6_27_2 doi: 10.1136/qshc.2006.020842 – volume: 10 start-page: 1 year: 2010 ident: e_1_2_6_22_2 article-title: Medication incidents occurring in long‐term care publication-title: ISMP Canada Safety Bulletin contributor: fullname: Institute for Safe Medication Practices Canada – ident: e_1_2_6_9_2 doi: 10.1001/archinte.164.5.545 – ident: e_1_2_6_24_2 doi: 10.1046/j.1440-1762.2001.00430.x – ident: e_1_2_6_20_2 doi: 10.1002/j.2055-2335.2009.tb00432.x – ident: e_1_2_6_3_2 – ident: e_1_2_6_17_2 doi: 10.1046/j.1532-5415.2003.51185.x – ident: e_1_2_6_23_2 doi: 10.1016/j.amjopharm.2008.10.001 – ident: e_1_2_6_6_2 – ident: e_1_2_6_12_2 – ident: e_1_2_6_8_2 doi: 10.1002/j.2055-2335.2009.tb00456.x – ident: e_1_2_6_19_2 doi: 10.1136/bmj.311.7001.376 – ident: e_1_2_6_7_2 doi: 10.1016/j.amjopharm.2005.01.001 – ident: e_1_2_6_18_2 doi: 10.1002/j.2055-2335.2007.tb00752.x – volume-title: Guidelines for Medication Management in Residential Aged Care Facilities year: 2002 ident: e_1_2_6_14_2 contributor: fullname: Australian Pharmaceutical Advisory Council – volume-title: Guiding Principles to Achieve Continuity in Medication Management year: 2005 ident: e_1_2_6_16_2 contributor: fullname: Australian Pharmaceutical Advisory Council – ident: e_1_2_6_2_2 doi: 10.1111/j.1741-6612.2009.00376.x – volume-title: Assessment Module 4. Medication Administration and Management year: 2010 ident: e_1_2_6_15_2 contributor: fullname: Aged Care Standards and Accreditation Agency – ident: e_1_2_6_13_2 doi: 10.2165/00002512-200320090-00002 – ident: e_1_2_6_25_2 doi: 10.1016/j.ijmedinf.2009.09.002 – ident: e_1_2_6_11_2 doi: 10.1007/s11606-009-0948-2 – ident: e_1_2_6_26_2 doi: 10.1001/jama.297.8.831 – ident: e_1_2_6_4_2 – volume-title: Australian/New Zealand Standard 4360: Risk Management ident: e_1_2_6_21_2 contributor: fullname: Standards Australia – ident: e_1_2_6_10_2 doi: 10.1016/j.amjopharm.2006.09.003
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Snippet	Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with... To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Telephone interviews with RCF staff were... Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with... Aim: To assess continuity of medication management during transition from hospital to residential care facilities (RCFs). Method: Telephone interviews with RCF... AIMTo assess continuity of medication management during transition from hospital to residential care facilities (RCFs).METHODTelephone interviews with RCF...
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SubjectTerms	Aged Aged care Aged, 80 and over continuity of patient care Continuity of Patient Care - organization & administration Drugs (Pharmaceuticals) Female Graphs Hospital discharge Hospitals Hospitals - standards Humans Male Management medication error Medication errors Medication Errors - prevention & control medication system Nursing homes Patient Discharge Patient Transfer - organization & administration Patients residential facility Residential Institutions Residential Treatment - organization & administration Retrospective Studies
Title	Gaps in continuity of medication management during the transition from hospital to residential care: An observational study (MedGap Study)
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