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Please reconcile, not wait a while
  1. Ashifa Trivedi1,
  2. Sadhna Sharma1,
  3. Richa Ajitsaria2,
  4. Nicola J Davey3
  1. 1 Pharmacy Department, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK
  2. 2 Department of Paediatrics, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK
  3. 3 Quality Improvement Clinic, Southampton, UK
  1. Correspondence to Ashifa Trivedi, Department of Paediatrics, Hillingdon Hospitals NHS Foundation Trust, Uxbridge UB8 3NN, UK; ashifa.trivedi{at}nhs.net

Abstract

A quality improvement project to increase the rate of paediatric medicines reconciliation was carried out in a district general hospital between April and July 2018. Baseline data collected from our paediatric ward shows that medicines reconciliation by doctors is only accurately completed 50% of the time. Evidence shows that medicines-related patient safety incidents are more likely when medicines reconciliation happens more than 24 hours after a person is admitted to an acute setting. The aim of this quality improvement project was therefore to ensure that 100% of paediatric patients have their regular medications prescribed by mid-day the day after admission. The paediatric pharmacy team reviewed all paediatric inpatient drug charts from Monday to Friday for 12 weeks. The number of regular medications and the number of medicines reconciled was recorded each day. The effectiveness of various interventions were reviewed using Plan–Do–Study–Act cycles. On average, 40 patients were reviewed each week. The mean reconciliation rate was 79%, and the worst rate was 0%. 100% reconciliation was achieved on 34 occasions and was achieved continuously for the last 3 weeks of data collection. A repeat audit carried out in September 2018 found the reconciliation rate was maintained at 100%. Multiple interventions occurred during this quality improvement project: teaching sessions for doctors, posters to raise awareness and questionnaires for parents/children to complete about their regular medications. The main factor for success in this project has been involving all members of the paediatric department including children and their parents.

  • general paediatrics
  • multidisciplinary team-care
  • paediatric practice
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Footnotes

  • Contributors AT conceived the idea for this quality improvement project and authored the manuscript. SS helped collect data for the project and contributed to the manuscript. RA and NJD provided advice and mentorship throughout the project. All authors have reviewed and had input into the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no unpublished data at this time.

  • Patient consent for publication Not required.

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