Implementation of a Robust Process to Gather an Accurate Home Medication List for Admitted Patients

An accurate home medication list serves as the 'source of truth' for the entire process of medication reconciliation. The hospital's home medication lists were found to be inaccurate 100 percent of the time and the organization lacked a systematic, evidence-based process for gathering a home medication list for admitted patients. The project objective was to develop a hospital process to increase the accuracy of the home medication list gathered for admitted patients using Lean Six Sigma methodologies. Key improvements included: (1) Identification and standardization of the process steps required to gather an accurate home medication list; (2) Development of an algorithm to guide staff decision making when gathering the list; and (3) Development of staff competency assessment. Implementation of the new process decreased the number of errors per patient home medication list from 15 errors per list (November 2012) to 1.8 errors per list (March 2014). The percentage of errors that could potentially cause patient harm decreased from 83 percent (November 2012) to 27.8 percent (March 2014).

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)