![]() ![]() Medication reconciliation (MedRec) reduces the risk of UMDs and harmful adverse drug events that increase hospitalization cost and length of stay. The majority occur during care transitions, when patients are admitted, transferred between units, or discharged home. More than 50% of hospitalized patients experience one or more unintentional medication discrepancies (UMDs), defined as unexplained differences in medication regimens across different sites of care, with some having the potential for significant harm. ConclusionsĬomplex interventions like the MARQUIS MedRec Toolkit can benefit from the ERIC taxonomy, but adaptations and new strategies (and even categories) are necessary to fully capture the range of approaches to implementation. Two new non-ERIC categories of strategies emerged-“Integration” and “Professional roles and responsibilities.” Of the 73 specific strategies in the ERIC taxonomy, 32 were used to implement the MARQUIS Toolkit and 11 new, and non-ERIC strategies were identified (e.g., aligning with existing initiatives and professional roles and responsibilities). Major categories of implementation strategies predominantly mirrored the ERIC strategies of “Plan,” “Educate,” “Restructure,” and “Quality Management.” Participants rarely used the ERIC strategies of finance and attending to policy context. Resultsĭata were collected from 16 hospitals using 2 focus groups, 3 group interviews, and 11 individual interviews, 10 sites’ meeting minutes, and an email interview of an executive. Interview data were transcribed and analyzed using content analysis and the constant comparison technique. Data consisted of transcripts from web-based focus groups and individual interviews, as well as meeting minutes. MethodsĪ qualitative study was conducted with implementation teams and executive leaders of hospitals participating in the federally funded “Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety” (known as MARQUIS2) research study. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, we report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit). How to best implement MedRec interventions remains unclear. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. ![]()
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