Evidence map›Paper›PMID 36229073›Full record

ArticleBMJ open quality2022

Interprofessional survey on medication reconciliation activities in the US Department of Veterans' Affairs: development and validation of an Implementation Readiness Questionnaire.

Blake Lesselroth, Victoria Lee Church, Kathleen Adams, Amanda Mixon, Amy Richmond-Aylor, Naomi Glasscock, Jack Wiedrick

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open quality, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Blake LesselrothDepartment of Medical Informatics, The University of Oklahoma-Tulsa, Tulsa, Oklahoma, USA blake-lesselroth@ouhsc.edu.ORCID 0000-0001-6170-7964
Victoria Lee ChurchUS Department of Veterans Affairs, Office of Nursing Services, Washington, DC, USA.
Kathleen AdamsUS Department of Veterans Affairs, Office of Human Factors Engineering, Washington, DC, USA.ORCID 0000-0003-4224-038X
Amanda MixonSchool of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Amy Richmond-AylorOffice of Specialty Care Services, Veterans Health Administration, Washington, DC, USA.
Naomi GlasscockSpecialty Care Services, Prescription Drug Monitoring Program, Veterans Health Administration, Washington, DC, USA.
Jack WiedrickBiostatistics & Design Program, Oregon Health & Science University, Portland, Oregon, USA.
United States Department of Veterans Affairs · USVeterans Health Administration · USOregon Health & Science University · USUniversity of Victoria · CAVanderbilt University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedication reconciliation (MR) can detect medication history discrepancies at interfaces-in-care and help avoid downstream adverse drug events. However, organisations have struggled to implement high-quality MR programmes. The literature has identified systems barriers, including technology capabilities and data interoperability. However, organisational culture as a root cause has been underexplored.

objectivesOur objectives were to develop an implementation readiness questionnaire and measure staff attitudes towards MR across a healthcare enterprise.

methodsWe developed and distributed a questionnaire to 170 Veterans' Health Affairs (VHA) sites using Research Electronic Data Capture (REDCap) software. The questionnaire contained 21 Likert-scale items that measured three constructs, such as: (1) the extent that clinicians valued MR; (2) perceptions of workflow compatibility and (3) perceptions concerning organisational climate of implementation.

results8704 clinicians and staff responded to our questionnaire (142 of 170 VHA facilities). Most staff believed reconciling medications can improve medication safety (approximately 90% agreed it was 'important'). However, most (approximately 90%) also expressed concerns about changes to their workflow. One-third of respondents prioritised other duties over MR and reported barriers associated with implementation climate. Only 47% of respondents agreed they had enough resources to address discrepancies when identified.

interpretationOur findings indicate that an MR readiness assessment can forecast challenges and inform development of a context-sensitive implementation bundle. Clinicians surveyed struggled with resources, technology challenges and implementation climate. A strong campaign should include clear leadership messaging, credible champions and resources to overcome technical challenges.

conclusionsThis manuscript provides a method to conduct a readiness assessment and highlights the importance of organisational culture in an MR campaign. The data can help assess site or network readiness for an MR change management programme.

Indexed as

Medication ReconciliationVeteransAttitude of Health PersonnelHumansOrganizational CultureSurveys and QuestionnairesUnited StatesHealthcare quality improvementImplementation scienceMedication reconciliationMedication safetySurveys

Identifiers

PMID36229073
PMCPMC9562315
OpenAlexW4306155159

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.