MARQUIS project marches toward better med reconciliation

The hospital also has faced hurdles such as the fact that most of the clinicians involved in this process have never been trained on taking a thorough medication history. And even more have never received feedback on the quality of their preadmission medication histories. "This is a core competency that none of us have really ever been trained around," Dr. Stein said.

Another barrier is being clear about who is responsible for making sure each patient has an accurate medication list. "Is it the admitting provider? Unless you’ve actually explicitly outlined whose role that is, it’s nobody’s," Dr. Stein said.

The MARQUIS researchers are collecting data on the number of potentially harmful unintentional medication discrepancies per patient. The researchers collect the raw data from each of the sites and then send it on to physicians who consider the context for the discrepancies and the potential for harm.

Another goal of the project is to try to figure out why certain interventions work in certain places. The researchers are conducting surveys, interviews, direct observation, and focus groups to get these answers. "That will help us understand what components work in what settings," said MARQUIS investigator Amanda H. Salanitro, a hospitalist and health services researcher at Vanderbilt University Medical Center and the VA Tennessee Valley Healthcare System.

mschneider@frontlinemedcom.com

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