Scanning system to expedite home medication reconciliation

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Scanning system to expedite home medication reconciliation

Scanning System to Expedite Home Medication Reconciliation

There are three main areas where patient information including home medication is captured into the EMR. These areas are: the emergency department, and impatient and outpatient registration. The new system will impact all of them directly as nurses wil no longer input the medication information manually but rather scan it into the system.

Work Flow Analysis

The Home Medication Reconciliation Scanning System, through a user friendly interphase, will capture, aggregate and organize medication information from different sources. It will interphase with pharmacy and EMR. The system will identify commonly made mistakes such as wrong dose or frequency and rely error messages to its end users in the form of audible sounds and pop up windows. Wireless scanners able to read both QR and bar codes in the medication bottles will be installed in each computer terminal in the areas where this information is collected.

Functional Requirements


-Implementation of this concept will take place in the impatient, outpatient registration and the emergency department of an acute care facility.-The facility has had patient admissions of upwards 218,079.-The steep amount of patient volume can lead to an input of incorrect information by clinicians and can also be cumbersome as well as time consuming. -A better more efficient system in this high acute workplace is warranted.

Introduction and Organizational Description

Literature was searched for the available current solutions to inputting information for medication reconciliations. The current method of developing a medication reconciliation is by manual entry through electronic medical records (Agrawal, 2009). This method of entering home medication(s) poses various issues including time constraints and errors in information entered (Barnsteiner, 2008). Medication reconciliation is of dire concern during the patients stay. An incorrectly entered medication reconciliation can lead to inaccurate dosing, interactions and consequent adverse events. Time constraints is an issue of concern when it relates to entering this information correctly, especially when the patient has an outstanding amount of medications to be compiled (Gleason et al., 2004). A viable solution that appears to be superior to the current method, is by compiling home medications with the use of an application that allows for barcode scanning of already placed labels on medication bottles. This streamlines the process and makes it far more efficient. In addition, it can decrease time spent in documenting and is a more reliable and accurate means of inputting information.


-Barnsteiner (2008), states it can take thirty to sixty minutes of time to compile a medication reconciliation. -Barnsteiner (2008) mentions how a full time staff may be needed to handle this task if frequent admissions and discharges are occurring in a department. -As per Gleason et al (2012), “conducting effective medication reconciliation on admission is estimated to take fifteen to thirty minutes” (p. 4). -In an article written by Beckett, Crank & Wehmeyer showed pharmacist spending a range of fifteen to thirty minutes per patient as a result of reviewing home medication reconciliations. -When summed, this can mean on average the process of establishing a medication reconciliation may consume thirty-eight to seventy-five minutes of time per patient admission.

Review of Literature

-Those impacted by the implementation of this system and that will be positioned as end users are clinicians working in these corresponding departments: emergency room, inpatient and outpatient registration services. -Upon reflection on the diffusion of innovation theory, management would be labeled as innovators.-Early adopters of this system would include nursing supervisors and charge nurses.-Early majority would be considered staff clinicians.-Late majority could be considered veteran nurses who may show reluctance to the change ("Diffusion of Innovation Theory," 2013).-This poster could serve as information on the use of this system and show evidence of why this method is currently more efficient and a safer alternative.


Organizational Readiness

The organization is not completely prepared, but is advanced, in that an already established scanning system is in place and in sync with the electronic software used at the facility. Application development along with its interoperability to the software would be needed along with cultivating a culture that is eager to apply and learn about the product. The training procedure of this system becomes facilitated from what is already known about scanning at this facility. Although, it is necessary for staff to become acclimated to the new procedural steps in compiling the medication reconciliation, which include: accessing the medication reconciliation tab, the system will then ask for the patient’s identification bracelet to be scanned, followed by a pop-up window that displays “scan home medication labels”. Once this is done medications will then be shown in a compiled format with all of its pertinent information, such as: dose, route, frequency, refills left, when the medication was dispensed and the prescribing doctor’s information.

The integration testing phase will begin once the software has been developed and the scanners installed. This phase is aimed to detect any software-hardware inconsistencies as well as any interoperability issues. A pilot test will follow in order to follow information from the end users in order to have a better insight of the functionality of the system. The unit chosen for this pilot is the outpatient registration unit. This is a slow paced unit that processes a fairly large number of patient cases each day.

The implementation of this new system will take place over a period of 30 days in three phases. Phase I will be inpatient admissions, phase II outpatient and finally phase III will incorporate the emergency department.This implementation model will provide ample time to have the end users properly trained and fully familiarized with the new system.


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