SHM Converge Scientific Abstract ePoster Gallery-Click for Cookies: Improving Trainee Ehr Use in Medication Reconciliation

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This quality improvement project aimed to increase internal medicine residents’ use of the electronic health record (EHR) medication reconciliation (MR) tab, since inconsistent documentation was causing redundancy and possible safety issues. At a quaternary academic center, the team found that residents often completed MR in notes instead of the dedicated EHR field.<br /><br />A pre-intervention survey of internal medicine residents showed variable practices and confusion about when MR should ideally be completed. The intervention, run from July to November 2022, combined education with gamification. Residents received a simplified online workflow guide every two weeks, and teams were publicly recognized with cookies for achieving the highest percentage of MR completed in the EHR. Only residents on wards were contacted to reduce email fatigue. Automated EHR reports tracked completion rates.<br /><br />Results showed substantial improvement. EHR documentation of MR increased from a baseline of 22.88% to an average of 53.56% during the intervention, and remained around 50% afterward. Safety data from the post-discharge call center suggested improvement as well: before the intervention, Medicine service patients generated 2 pharmacy referrals and 13 medication interventions in June 2022, while after implementation there were 0 pharmacy escalations and an average of 11 medication interventions per month.<br /><br />Overall, the project suggests that a simple workflow redesign paired with positive reinforcement and gamification can improve resident behavior, increase use of structured EHR documentation, and may contribute to better medication safety.

Asset Subtitle

Sophia Golec

Meta Tag

Author List Anne S. Linker, Jeffrey D. Epstein, Sophia Golec, Vinh-Tung P. Nguyen

Category Innovations

Concept Medication Reconciliation

Concept Patient Safety

Concept Documentation

Concept Medication Error

Concept Electronic Health Record

Distinguished Non-Finalist

Presenter Organization Mount Sinai Hospital

Presenting Author Sophia Golec

Track Quality Improvement

Keywords

medication reconciliation

electronic health record

internal medicine residents

quality improvement

EHR documentation

gamification

workflow redesign

patient safety

resident education

structured documentation

Medication Reconciliation

Patient Safety

Documentation

Medication Error

Electronic Health Record