High 5s medication reconciliation project
The High 5s Project is a patient safety collaboration among a group of countries and the WHO Collaborating Centre for Patient Safety in support of the WHO Patient Safety Program. The Australian Commission on Safety and Quality in Health Care (the Commission) is the lead technical agency for the project in Australia. The project "Assuring medication accuracy at transitions of care", through the process of medication reconciliation, is one of five evidence based solutions for patient safety within the High 5s project.Australia is one of ten countries participating in the High 5s program. Other countries include: the United Kingdom, USA, Canada, France, Germany, the Netherlands, and Singapore.
The major components of the High 5s Project include the development and implementation of problem-specific Standardised Operating Protocols (SOPs); creation of a comprehensive evaluation strategy; collection, reporting, and analysis of data; and the establishment of an electronic collaborative learning community. The High 5s Project is designed to generate learning that will permit the continuous refinement and improvement of the SOPs, as well as assessment of the feasibility and success of implementing standardised approaches to specific patient safety problems across multiple countries and cultures. Achievement of the Project goals is expected to provide valuable lessons and new knowledge to support the advancement of patient safety around the world. Further information about the High 5s Project is available from http://www.high5s.org/bin/view.
Communication problems between settings of care are a significant factor in the occurrence of medication errors and adverse medicines events. The process of medication reconciliation has been shown to reduce adverse medicines events as patients move from one setting of care to another. The High 5s Medication Reconciliation SOP addresses the prevention of medication errors resulting from incomplete or miscommunication of information at points of transition in the patient care process, such as admission to hospital, transfers within the hospital, and discharge from the hospital. The SOP incorporates the process of:
- obtaining a complete and accurate list of each patient's current home medications;
- using the list when writing admission, transfer and/or discharge medication orders, and
- comparing the list against the patient's admission, transfer, and/or discharge orders, identifying and bringing any discrepancies to the attention of the prescriber and, if appropriate, making changes to the orders.
Nineteen hospitals from five Australian states have been recruited to participate in the medication reconciliation project. The hospitals will test the feasibility of implementing the medication reconciliation SOP across a range of health care settings and evaluate the effectiveness of the process.
This is a five year project. The first phase of the project is the introduction of medication reconciliation in patients 65 years of age and older who are admitted to a medical ward from the emergency department. In subsequent phases, the scope will be expanded to include all patients at all entry points to inpatient and outpatient settings.
The project will commence in early 2010.
Inquires about the project should be emailed to mail@safetyandquality.gov.au
