Improving medication reconciliation compliance in a tertiary care hospital of a developing country: a quality improvement initiative using the PDSA cycle
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| Veröffentlicht in: | BMJ Open Quality vol. 14, no. 4 (2025), p. e003487 |
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| 001 | 3260550371 | ||
| 003 | UK-CbPIL | ||
| 022 | |a 2399-6641 | ||
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| 024 | 7 | |a 10.1136/bmjoq-2025-003487 |2 doi | |
| 035 | |a 3260550371 | ||
| 045 | 2 | |b d20250101 |b d20251231 | |
| 084 | |a 269939 |2 nlm | ||
| 100 | 1 | |a Sabeen Ahmed Amber |u Medicine , The Aga Khan University , Karachi , Sindh , Pakistan | |
| 245 | 1 | |a Improving medication reconciliation compliance in a tertiary care hospital of a developing country: a quality improvement initiative using the PDSA cycle | |
| 260 | |b BMJ Publishing Group LTD |c 2025 | ||
| 513 | |a Journal Article | ||
| 520 | 3 | |a BackgroundMedication reconciliation is a critical process for ensuring patient safety by preventing medication errors, especially at hospital admission. Despite its importance, compliance with this process in our internal medicine ward was alarmingly low, with an initial baseline of only 4% compliance in January 2019. This prompted the initiation of a quality improvement (QI) project aimed at improving adherence to the medication reconciliation process.MethodsA team-based approach was implemented, including junior doctors, nurses, pharmacists and the hospital’s information technology team. The plan-do-study-act (PDSA) methodology was used to design, test and implement interventions. Key interventions included educational sessions for junior doctors, integration of pharmacy systems for easy access, daily reminders via a WhatsApp group, and reinforcement of the process by senior residents. Data collection was standardised, tracking patient demographics, reconciliation times and team responsibilities. Compliance was monitored over a 4-month intervention period.ResultsAt the start of the intervention, medication reconciliation compliance was at 4%. Initial progress was slow, requiring frequent reminders and educational sessions. However, by the end of the first month, compliance had reached 77%, and by the end of the 4-month period, it improved to 96%, surpassing the target of 90%. This improvement was sustained with a compliance rate above 90% for 6 months following the intervention.ConclusionsThe use of the PDSA methodology significantly improved medication reconciliation compliance, achieving a 96% adherence rate. Engaging healthcare staff through education, clear communication and a team-based approach was key to overcoming barriers and ensuring sustainable improvements. This model can be applied to other QI projects aimed at enhancing patient safety and reducing preventable harm. | |
| 653 | |a Patient safety | ||
| 653 | |a Medicine | ||
| 653 | |a Teams | ||
| 653 | |a Documentation | ||
| 653 | |a Computer terminals | ||
| 653 | |a Intervention | ||
| 653 | |a Medical personnel | ||
| 653 | |a Initiatives | ||
| 653 | |a Quality improvement | ||
| 653 | |a Internal medicine | ||
| 653 | |a Hospitals | ||
| 653 | |a Drug stores | ||
| 653 | |a Data collection | ||
| 653 | |a Developing countries--LDCs | ||
| 653 | |a Compliance | ||
| 653 | |a Workloads | ||
| 653 | |a Medical errors | ||
| 653 | |a Physicians | ||
| 653 | |a Accountability | ||
| 653 | |a Sustainable development | ||
| 653 | |a Health care | ||
| 653 | |a Patient admissions | ||
| 653 | |a Reconciliation | ||
| 653 | |a Information technology | ||
| 700 | 1 | |a Aziz, Abdul |u The Aga Khan University , Karachi , Sindh , Pakistan | |
| 700 | 1 | |a Sethi, Sher Muhammad |u The Aga Khan University Hospital , Karachi , Pakistan | |
| 773 | 0 | |t BMJ Open Quality |g vol. 14, no. 4 (2025), p. e003487 | |
| 786 | 0 | |d ProQuest |t Consumer Health Database | |
| 856 | 4 | 1 | |3 Citation/Abstract |u https://www.proquest.com/docview/3260550371/abstract/embedded/L8HZQI7Z43R0LA5T?source=fedsrch |
| 856 | 4 | 0 | |3 Full Text + Graphics |u https://www.proquest.com/docview/3260550371/fulltextwithgraphics/embedded/L8HZQI7Z43R0LA5T?source=fedsrch |
| 856 | 4 | 0 | |3 Full Text - PDF |u https://www.proquest.com/docview/3260550371/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch |