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Medication review program keeps patients safe

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The culture of quality improvement at Runnymede Healthcare Centre has inspired the creation of a new pharmacy initiative that is receiving national recognition as an outstanding model for enhancing patient safety.

Through regular reviews of medication regimens, pharmacy team members help ensure that patients are receiving only the medicines they absolutely need. By incorporating students from the University of Toronto’s Faculty of Pharmacy into this process, patient safety is strengthened and the students gain an enriching learning experience.

Before being admitted to Runnymede, medically complex patients are often treated by multiple physicians, for multiple health issues. As patients transition from one level of care to another, the number of medicines they are prescribed can add up – regimens sometimes consist of more than 20 different medications. This can potentially lead to negative side effects or unintended interactions between drugs which, if serious enough, can cause patients to require treatment in an acute care hospital.

By performing comprehensive assessments of the medications in patients’ regimens, Runnymede’s pharmacy team evaluates the risk of drug interactions. They also review the patient’s medical history and make recommendations about whether certain drugs could be discontinued, or if dosages might be lowered. Pharmacists, pharmacy students and physicians work collaboratively with patients to ensure that medication changes are patient-centered.

"The pharmacists work in close collaboration with other healthcare professionals at the hospital to ensure the most appropriate medications are provided to our patients," explains Manager of Pharmacy and Allied Health, Luba Kelebay. "Our team saw an opportunity to enhance our medication review process and further contribute to patients’ safety."

The hospital’s pharmacy students have specialized training in geriatric medicine and were recognized to be a helpful asset. "With our guidance, students conduct comprehensive reviews of patient charts and make evidence-based suggestions on how their medication use could be enhanced," said Hilary Rodrigues, Runnymede’s professional practice leader – pharmacy. "They also talk with the patients and clinical staff to learn about the patients’ treatment goals and values, which can help inform the recommendations that they make."

The initiative has been a great success, with physicians at Runnymede implementing more than three-quarters of the department’s recommendations. The Canadian Society of Hospital Pharmacists (CSHP) also recognized the value of the initiative and invited Runnymede’s pharmacy team to present an overview of the initiative and the benefits it provides at the CSHP Professional Practice Conference in February, 2016.

"Our initiative is a win for everybody," says Kelebay. "Patients are safer when we optimize their medications; we lower hospital costs when unnecessary medications are removed and pharmacy students get a very valuable learning experience while they’re here."

Next: Runnymede redefines possible with five-year plan