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2011 QUALITY IMPROVEMENT INITIATIVES

Patient Safety Project: Medication Safety Program
 
Updated evaluation – 2011 and ongoing

Since October of 2010 the number of community members utilizing the service of Medicine on Time® has increased by 10%. This continues to be a valuable service to the Grace Cottage Hospital community. By providing this service Grace Cottage Hospital is allowing community members who would otherwise require Nursing Home Placement the opportunity to remain in their homes. As the service increases word of mouth has caused other area physicians to refer their patients for this service.

Problem
Grace Cottage Hospital began seeing increases in the number of hospital admissions for people over the age of 65 due to medication-related problems caused by the patient’s confusion, forgetfulness or a misunderstanding of how/when to take their medications. 2010 Census data shows that Vermont has the second most aged population in the country following Maine, and that the West River Valley area is one of the fastest aging areas in Vermont. The medical and pharmacy staff decided that with a growing elderly demographic, the problem of medication mismanagement/forgetfulness would only increase over time.
      
Goals:
The goal of this project was to devise a plan to allow patients of Grace Cottage to stay in their own homes and safely manage their medication(s).

Intervention Process:
The hospital’s senior leadership team agreed to fund the Medicine On Time™  program at the hospital’s outpatient pharmacy, Messenger Valley Pharmacy. In the fall of 2010, the pharmacy staff presented the benefits of the program to the medical staff who could recommend the medication program to their patients. Using this program, when a physician prescribes a medication for a patient, the pharmacist determines the best time for the medication to be taken by the patient. This prescription information is input into the pharmacy’s computer system which interfaces with the Medicine On Time™ computerprogram. Medicine On Time™  will then print on glued foil the name of the medication, date to be taken and time to be taken. The pills are placed into a bubble sheet allowing for a one-month supply of medication, and then sealed. Each time of day (e.g. breakfast, lunch, dinner, bed time) is color-coded on the bubble pack. When the pills are due to be taken, the foil is peeled off the back of the bubble, which then becomes a medicine cup, so that the correct medication and correct quantity is taken at the correct time. This system can be used for one pill or for many pills.

Evaluation:
Grace Cottage will monitor the number of patients who are enrolled in the Medicine On Time™  program. The hospital will monitor the number of readmissions due to medication-related problems for patients enrolled in the program. And the medical staff will monitor the medication compliance of their patients during their regular office visits and bloodwork.