Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation

Abstract Background The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUI...

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Main Authors: Amanda S. Mixon (Author), G. Randy Smith (Author), Meghan Mallouk (Author), Harry Reyes Nieva (Author), Sunil Kripalani (Author), Stephanie Rennke (Author), Eugene Chu (Author), Anirudh Sridharan (Author), Anuj Dalal (Author), Stephanie Mueller (Author), Mark Williams (Author), Tosha Wetterneck (Author), Jason M. Stein (Author), Deonni Stolldorf (Author), Eric Howell (Author), John Orav (Author), Stephanie Labonville (Author), Brian Levin (Author), Catherine Yoon (Author), Marcus Gresham (Author), Jenna Goldstein (Author), Sara Platt (Author), Christopher Nyenpan (Author), Jeffrey L. Schnipper (Author), the MARQUIS2 Site Leaders (Author), the MARQUIS2 Study Group (Author)
Format: Book
Published: BMC, 2019-09-01T00:00:00Z.
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MARC

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100 1 0 |a Amanda S. Mixon  |e author 
700 1 0 |a G. Randy Smith  |e author 
700 1 0 |a Meghan Mallouk  |e author 
700 1 0 |a Harry Reyes Nieva  |e author 
700 1 0 |a Sunil Kripalani  |e author 
700 1 0 |a Stephanie Rennke  |e author 
700 1 0 |a Eugene Chu  |e author 
700 1 0 |a Anirudh Sridharan  |e author 
700 1 0 |a Anuj Dalal  |e author 
700 1 0 |a Stephanie Mueller  |e author 
700 1 0 |a Mark Williams  |e author 
700 1 0 |a Tosha Wetterneck  |e author 
700 1 0 |a Jason M. Stein  |e author 
700 1 0 |a Deonni Stolldorf  |e author 
700 1 0 |a Eric Howell  |e author 
700 1 0 |a John Orav  |e author 
700 1 0 |a Stephanie Labonville  |e author 
700 1 0 |a Brian Levin  |e author 
700 1 0 |a Catherine Yoon  |e author 
700 1 0 |a Marcus Gresham  |e author 
700 1 0 |a Jenna Goldstein  |e author 
700 1 0 |a Sara Platt  |e author 
700 1 0 |a Christopher Nyenpan  |e author 
700 1 0 |a Jeffrey L. Schnipper  |e author 
700 1 0 |a the MARQUIS2 Site Leaders  |e author 
700 1 0 |a the MARQUIS2 Study Group  |e author 
245 0 0 |a Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation 
260 |b BMC,   |c 2019-09-01T00:00:00Z. 
500 |a 10.1186/s12913-019-4491-5 
500 |a 1472-6963 
520 |a Abstract Background The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. Methods MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site's local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. Discussion A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation. 
546 |a EN 
690 |a Medication reconciliation 
690 |a Patient safety 
690 |a Hospital medicine 
690 |a Transitions in care 
690 |a Medication errors 
690 |a Quality improvement 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n BMC Health Services Research, Vol 19, Iss 1, Pp 1-10 (2019) 
787 0 |n http://link.springer.com/article/10.1186/s12913-019-4491-5 
787 0 |n https://doaj.org/toc/1472-6963 
856 4 1 |u https://doaj.org/article/7f82d19d2bf74f6fb180b6ab67702938  |z Connect to this object online.