Creation of a Patient-Friendly Daily Hospital Medication Schedule

Creation of a Patient-Friendly Daily Hospital Medication Schedule

Rebecca Caschette, RN, MS Administrator of Quality & Patient SafetyMemorial Healthcare SystemHollywood, Florida

Jodi Fredericks, Pharm.D., MBA Pharmacy Safety & Medication Officer Memorial Healthcare SystemHollywood, Florida

Memorial Healthcare System

Memorial Healthcare System

• Not-for-profit public hospital 5th largest public healthcare system in the

country.

• 1,773 licensed beds

• Level 1 Trauma Center

• 4 Primary Care Centers

• Nursing Home

• Home Health

• Wound Care

• Cancer Institute and Breast Centers

• Urgent Care Center

Network for Healthcare Improvement

(http://www.nrhi.org/downloads/system_quality_and_HCAHPS_scores_Q3_2006_to_Q2_2007UPDATED.pdf)

Winner of the Premier Award for Quality (AFQ), June 9, 2010. One of only three healthcare systems nationwide to earn this distinction for leading healthcare organizations that provide efficient, outstanding patient care and consistently set the standard in clinical excellence.

RANK COMPANY HEADQUARTERS INDUSTRY

1 Shared Technologies Coppell, Texas Telecommunications

2 Third Federal Savings Cleveland Banking

3 HOK St. Louis, Mo. Architecture

4 Inktel Direct Miami Lakes Advertising/ PR/ Marketing

5 Fairwinds Credit Union Orlando Credit Union

6 PMA Companies Blue Bell, Pa. Insurance

7 FCCI Insurance Group Sarasota Insurance

8 Edward Jones St. Louis, Mo. Financial Services

9 USAA San Antonio, Texas Financial Services

10 Balfour Beatty Construction Dallas Construction

11 Navy Federal Credit Union Vienna, Va. Credit Union

12 CA Inc. Islandia, N.Y. Technology

13 Wharton-Smith Sanford Construction

14 Hunton & Williams LLP Richmond, Va. Legal

15 Amadeus North America Miami Technology/Travel

16 Memorial Healthcare System Hollywood Healthcare

17 Sierra Nevada Corp. Sparks, Nev. Engineering

18 Gaylord Palms Resort & Convention Center Nashville Hotel

19 Skanska USA Building New York, N.Y. Construction

20 Gunster, Attorneys at Law West Palm Beach Legal

The Best Companies To Work For in Florida program was created by Florida Trend Magazine and Best Companies.

For the second consecutive year Memorial Healthcare System has been named one of Florida’s 100 Best Companies to Work For – and the top-ranked healthcare system on the list.

The application was a two-part process. First, evaluating workplace policies, practices, philosophy, systems and demographics; and second, a confidential employee survey to measure employee satisfaction. The combined scores determined the top companies and the final ranking.

Objectives of Project• To empower the patient and family members

with knowledge about the medications the patient will receive while in the hospital

• To increase patient and family participation in care and knowledge/information about medications received while in the hospital

• To partner with and engage the patient and family members in becoming a vital part of the healthcare team in order to make the patient’s hospital stay safe

Patient-Friendly Daily Medication Schedule

• Created with the help of our IT Clinical Informatics Department

• Pulls from our nursing MAR but puts it in patient friendly terms

• Received input and feedback from our Patient and Family Advisory Board

• Presented to many different System Committees and to Hospital Leaders

• Newsletter articles to help publicize

DAILY HOSPITAL MEDICATION SCHEDULE Date: 03/13/2009 0701 to 03/14/2009 0700

Program: IPP950SD Printed on: March 13, 2009 03:30 am Page 1 ________________________________________________________________________________________________ TEST, PATIENT ADMIT DATE: 03/11/2009 MEDICAL RECORD # 1234567 HT: 5 ft 6 in / 175 cm AGE: 45y SEX: F ROOM/BED: 8CEN 803-2 WT: 168 lbs / 76.5 kgs DOB: 03/18/1962 ALLERGIES: NO KNOWN DRUG ALLERGIES MEDICATIONS DOSE ROUTE HOW OFTEN MEDICATION SCHEDULED TIMES* Brand (generic) 03/13/2009 0701 - 03/14/2009 0700

*LOPRESSOR (METOPROLOL) 50 MG BY MOUTH DAILY 09:00AM ASPIRIN 82 MG BY MOUTH DAILY 09:00 AM CAPOTEN (CAPTOPRIL) 25 MG BY MOUTH 2 TIMES A DAY 09:00AM 09:00PM COLACE (DOCUSATE SO) 100 MG BY MOUTH AT BEDTIME 09:00PM NITROGLYCERIN OINTMENT 1 INCH ON THE SKIN EVERY 6 HOURS 05:00AM 11:00AM 05:00PM 11:00PM ROCEPHIN (CEFTRIAXONE) 1 GRAM INTRAVENOUS EVERY 24 HOURS 11:30AM LASIX (FUROSEMIDE) 40 MG INTRAVENOUS EVERY 8 HOURS 06:00AM 02:00PM 10:00PM

This list of hospital medications may change daily. Your final list will be provided to you upon discharge. *Please note that the medication scheduled times listed on this report may vary up to one hour before or after the actual times at which you receive your medications. ** New Medication started today. NOT FOR PERMANENT STORAGE IN THE MEDICAL RECORD

*END OF REPORT*

Patient-FriendlyDaily Medication Schedule

• Met with nursing leadership and nurse managers to provide education about the tool

• Staff were empowered to determine how to operationalize the new tool, with the understanding that the medication schedule must be distributed to each patient daily

• Provided in-services to nursing staff

• Rounded- Received feedback from patients, families, nursing, and other hospital staff

Patient FeedbackPATIENT FRIENDLY MAR SURVEY QUESTIONS 3/5/08 THRU 5/08/08

83 83

11

28

41

65

43

610

73

47

6

12

43

117

16

25

53

23

14

0

10

20

30

40

50

60

70

80

90

Was the formuseful to you?

Are thenurses/pharmexplaining themeds to you?

Is there anythingwe can do tomake it more

useful?

Did you ask for orreceive writteninstructions?

Are you receivingthe form daily?

Does thisform/info helpyour family?

Have you used theform to speakwith your MDabout meds?

Perc

enta

ge re

spon

ses/

tota

l sur

veye

d

Yes

No

N/A

Patient Feedback• Helps them learn about their medications

• Used to discuss new medications and to talk to doctor about their medications

• Provides them with information about their medications

• Now they know something about what they are taking while they are in the hospital

• Helped catch mistakes!

• They wish all hospitals would have this for them

• All very positive and excited about it

Keys to Success of the Project

• Patient and Family Advisory Board providing input and helping create the tool

• Piloting the tool in one unit of one hospital before going System-wide with the tool

• Receiving feedback from patients, families,

nursing, and other hospital staff

• Support from Administration and Nursing Leadership

• Transparency

Summary

• A daily hospital medication schedule helps empower the patient with knowledge about the medications he/she will receive while in the hospital and increases patient and family participation in care. It also helps catch potential medication errors.

• The report is given out to ALL inpatients and/or their family members by the nurse on a daily basis.

We challenge you to partner with and engage the patient and family members in becoming a vital part of the healthcare team by giving them a daily hospital medication schedule.