SHM Converge Scientific Abstract ePoster Gallery-Medication Reconciliation Upon Icu Transfer (Merit) to the Floor

Pdf Summary

The MERIT project (“Medication Reconciliation Upon ICU Transfer”) aimed to improve medication safety during transitions from the MICU to the floor. Because medications are often continued automatically after ICU transfer, the team created a MERIT note for MICU fellows to document plans for de-escalating high-risk medications and supporting formal medication reconciliation.<br /><br />After the first PDSA cycle, chart review showed only 9% of eligible transfers had a completed MERIT note. The project goal was to increase completion to 25% by December 2024 and then examine whether prescribing of high-risk medications at discharge decreased.<br /><br />Root cause analysis identified gaps in awareness and workflow. In response, the team added project education to resident and fellow MICU orientation and emphasized MERIT as part of the transfer bundle. In PDSA cycle 2, responsibility for completing the MERIT note expanded from MICU fellows alone to include clinical pharmacy specialists. The team also gathered voice-of-customer feedback from MICU stakeholders to refine the process.<br /><br />Chart review data were collected from October 2022 to October 2023 to track MERIT note completion and later prescribing patterns. Future work includes obtaining updated data since October 2023, focusing PDSA cycle 3 on medications most likely to be de-escalated before discharge, and determining next steps as the project moves beyond the implementation phase. Results will be shared with pharmacy and quality improvement leadership.

Asset Subtitle

Christopher v. Bastos

Meta Tag

Author List Christopher v. Bastos, Michael DiCesare, Oscar Mitchell, Shannon Lawson

Category Innovations

Concept Medication Reconciliation Upon ICU Transfer

Concept Medication Reconciliation

Concept ICU Transfer

Concept De-escalation

Concept High-Risk Medication

Distinguished Non-Finalist

Presenter Organization Hospital of the University of Pennsylvania

Presenting Author Christopher v. Bastos

Track Quality Improvement

Keywords

MERIT project

medication reconciliation

ICU transfer

MICU

high-risk medications

PDSA cycle

patient safety

clinical pharmacy

workflow improvement

discharge prescribing

Medication Reconciliation Upon ICU Transfer

Medication Reconciliation

ICU Transfer

De-escalation

High-Risk Medication