SHM Converge Scientific Abstract ePoster Gallery-An Interdisciplinary Approach to Improving Admission Medication Reconciliation Compliance

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Los Angeles General Medical Center set a National Patient Safety Goal to complete admission medication reconciliation (“admit med rec”) within 24 hours for 90% of patients. In September 2023, hospital-wide compliance was 67%, and Internal Medicine (IM), the highest-volume service, was only 57%. The quality improvement project aimed to raise hospital-wide compliance to 90% within one year by focusing on IM.<br /><br />Using five targeted Plan-Do-Study-Act (PDSA) cycles, the team implemented interdisciplinary interventions, especially daily team-specific reminders to residents and attendings. The approach was scaled across all 12 IM teams. A Transition of Care pharmacist also supported primary teams to improve sustainability.<br /><br />Results showed meaningful improvement. IM admit med rec compliance increased from 56.5% pre-intervention to 81.1% post-intervention, and hospital-wide compliance increased from 67.2% to 83.7%; both improvements were statistically significant (p = .0001). The project ultimately achieved the 90% goal for IM in 11 months and for the hospital overall in 10 months. IM compliance at 90% was sustained for three months (October to December 2024).<br /><br />The project found that frequent, daily reminders were highly effective, and the largest gains came from concentrating on the high-volume IM service. When messaging frequency was reduced in the final PDSA cycle, compliance declined slightly. Limitations included uncertain generalizability to other departments and reduced impact on weekends and holidays.<br /><br />Next steps include spreading the intervention to other departments, tailoring strategies to local needs, and further evaluating sustainability and culture change. Future efforts should also emphasize resident education on accurate medication reconciliation completion.

Asset Subtitle

Hannah Obasi

Meta Tag

Author List Claudia Orozco, Hannah Obasi, Nha Uyen Tuong Ngo, Soodtida Tangpraphaphorn

Category Research

Concept Medication Reconciliation

Concept Medication Discrepancy

Concept PDSA Cycle

Concept Medication Reconciliation Compliance

Concept Medication Duplication

Distinguished Non-Finalist

Presenter Organization Los Angeles General Medical Center

Presenting Author Hannah Obasi

Track Quality Improvement

Keywords

admission medication reconciliation

patient safety goal

quality improvement

PDSA cycles

internal medicine

hospital compliance

transition of care pharmacist

resident reminders

medication reconciliation

Los Angeles General Medical Center

Medication Reconciliation

Medication Discrepancy

PDSA Cycle

Medication Reconciliation Compliance

Medication Duplication