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Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS)

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Mass General Brigham

Status

Completed

Conditions

Adverse Drug Events
Medication Administered in Error

Treatments

Other: Mentored medication reconciliation quality improvement

Study type

Interventional

Funder types

Other
Other U.S. Federal agency

Identifiers

NCT01337063
2010P001814
1R18HS019598 (U.S. AHRQ Grant/Contract)

Details and patient eligibility

About

Patients often have problems after they leave the hospital, in part because errors are made in the medications they are prescribed. The goal of this project is to develop a more accurate and safe medication prescription process when patients enter and leave the hospital and implement this process at six U.S. hospitals. The investigators will measure the success of the project and develop lessons learned so this process can be applied to other hospitals.

Full description

Unintentional medication discrepancies during transitions in care (such as hospitalization and subsequent discharge) are very common and represent a major threat to patient safety. One solution to this problem is medication reconciliation. In response to Joint Commission requirements, most hospitals have developed medication reconciliation processes, but some have been more successful than others, and there are reports of pro-forma compliance without substantial improvements in patient safety. There is now collective experience about effective approaches to medication reconciliation, but these have yet to be consolidated, evaluated rigorously, and disseminated effectively.

This project's findings should provide valuable lessons to all hospitals regarding the best ways to design and implement medication reconciliation interventions to improve medication safety during transitions in care.

SPECIFIC AIMS:

Aim 1: Develop a toolkit consolidating the best practice recommendations for medication reconciliation

Aim 2: Conduct a multi-center mentored quality improvement project in which each site adapts the tools for its own environment and implements them

Aim 3: Assess the effects of a mentored medication reconciliation quality improvement intervention on unintentional medication discrepancies with potential for patient harm

Aim 4: Conduct rigorous program evaluation to determine the most important components of a medication reconciliation program and how best to implement it

Enrollment

1,836 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age 18 and over
  • Admitted to inpatient medical or surgical services

Exclusion criteria

  • Vulnerable populations (pregnant women, prisoners, institutionalized individuals)
  • Under 18 years

Hospital staff subjects:

  • Personnel directly involved in the medication reconciliation process, which depending on the site might include residents, physician assistants, inpatient attending physicians, nurses, pharmacists, and pharmacy technicians.

Trial design

Primary purpose

Health Services Research

Allocation

Non-Randomized

Interventional model

Single Group Assignment

Masking

None (Open label)

1,836 participants in 2 patient groups

Pre-intervention
No Intervention group
Description:
Usual care regarding medication reconciliation as currently practiced at each participating site.
Intervention
Experimental group
Description:
Improved medication reconciliation process using continuous quality improvement methods, mentored implementation, and an implementation guide.
Treatment:
Other: Mentored medication reconciliation quality improvement

Trial contacts and locations

6

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Data sourced from clinicaltrials.gov

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