Design of MARQUIS2: Study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation

Amanda S. Mixon, G. Randy Smith, Meghan Mallouk, Harry Reyes Nieva, Sunil Kripalani, Stephanie Rennke, Eugene Chu, Anirudh Sridharan, Anuj Dalal, Stephanie Mueller, Mark Williams, Tosha Wetterneck, Jason M. Stein, Deonni Stolldorf, Eric Howell, John Orav, Stephanie Labonville, Brian Levin, Catherine Yoon, Marcus GreshamJenna Goldstein, Sara Platt, Christopher Nyenpan, Jeffrey L. Schnipper, Sanchita Sen, Samer Badr, Michelle Murphy, Corrie Vasilopoulos, Tara Vlasimsky, Christine Roussel, Olugbenga Arole, Loredana Diana Berescu, Arif Arifuddowla, Hattie Main, Susan Pickle, Cristy Singleton, Brenda Asplund, Andrea Delrue, Andrea Forgione, Colleen Shipman, Luigi Brunetti, Hina Ahmed, Adrian Gonzales, Mithu Molla, Sarah Bojerek, Andrea Nguyen, Robert El-Kareh, Kyle Koenig, Loutfi Succari, Scott Kincaid, Pamela Proctor, Robert Pendleton, Amy Baughman, Kimberly Boothe, Katarzyna Szablowski, Olukemi Akande, Eric Tichy, Chi Zheng, Ryan Centafont, Regina Jahrstorfer, Lisa Jaser, Isha John, Margaret Curtin, Jenna Swindler, Joe Marcus, Robert Osten, Tian Yaw, Zainulabdeen Al-Jammali, Nancy Doherty, Brandi Hamilton, Magdee Hugais, Samson Lee, Paul Sabatini, Eddie Eabisa, Jennifer Mello, Julianna Burton, Edward Fink, Anthony Biondo, Trina Huynh, Ken Kormorny, Adonice Khoury, Kathryn Ruf, Dwayne Pierce, Chadrick Lowther, Karli Edholm, Shantel Mullin, Nicole Murphy, Jeni Norstrom, Laura Driscoll, Maribeth Cabie, Andrew Cadorette, Sara John, Amy D'Silva, Lionel Picot-Vierra

    Research output: Contribution to journalArticle

    Abstract

    Background: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. Methods: MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site's local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. Discussion: A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.

    Original languageEnglish (US)
    Article number659
    JournalBMC Health Services Research
    Volume19
    Issue number1
    DOIs
    StatePublished - Sep 11 2019

    Fingerprint

    Medication Reconciliation
    Patient Safety
    Electronic Health Records
    Practice Guidelines
    Hospitalists
    Medical Informatics
    Quality Improvement
    Caregivers
    Counseling
    Teaching
    Education

    Keywords

    • Hospital medicine
    • Medication errors
    • Medication reconciliation
    • Patient safety
    • Quality improvement
    • Transitions in care

    ASJC Scopus subject areas

    • Health Policy

    Cite this

    Design of MARQUIS2 : Study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation. / Mixon, Amanda S.; Smith, G. Randy; Mallouk, Meghan; Nieva, Harry Reyes; Kripalani, Sunil; Rennke, Stephanie; Chu, Eugene; Sridharan, Anirudh; Dalal, Anuj; Mueller, Stephanie; Williams, Mark; Wetterneck, Tosha; Stein, Jason M.; Stolldorf, Deonni; Howell, Eric; Orav, John; Labonville, Stephanie; Levin, Brian; Yoon, Catherine; Gresham, Marcus; Goldstein, Jenna; Platt, Sara; Nyenpan, Christopher; Schnipper, Jeffrey L.; Sen, Sanchita; Badr, Samer; Murphy, Michelle; Vasilopoulos, Corrie; Vlasimsky, Tara; Roussel, Christine; Arole, Olugbenga; Berescu, Loredana Diana; Arifuddowla, Arif; Main, Hattie; Pickle, Susan; Singleton, Cristy; Asplund, Brenda; Delrue, Andrea; Forgione, Andrea; Shipman, Colleen; Brunetti, Luigi; Ahmed, Hina; Gonzales, Adrian; Molla, Mithu; Bojerek, Sarah; Nguyen, Andrea; El-Kareh, Robert; Koenig, Kyle; Succari, Loutfi; Kincaid, Scott; Proctor, Pamela; Pendleton, Robert; Baughman, Amy; Boothe, Kimberly; Szablowski, Katarzyna; Akande, Olukemi; Tichy, Eric; Zheng, Chi; Centafont, Ryan; Jahrstorfer, Regina; Jaser, Lisa; John, Isha; Curtin, Margaret; Swindler, Jenna; Marcus, Joe; Osten, Robert; Yaw, Tian; Al-Jammali, Zainulabdeen; Doherty, Nancy; Hamilton, Brandi; Hugais, Magdee; Lee, Samson; Sabatini, Paul; Eabisa, Eddie; Mello, Jennifer; Burton, Julianna; Fink, Edward; Biondo, Anthony; Huynh, Trina; Kormorny, Ken; Khoury, Adonice; Ruf, Kathryn; Pierce, Dwayne; Lowther, Chadrick; Edholm, Karli; Mullin, Shantel; Murphy, Nicole; Norstrom, Jeni; Driscoll, Laura; Cabie, Maribeth; Cadorette, Andrew; John, Sara; D'Silva, Amy; Picot-Vierra, Lionel.

    In: BMC Health Services Research, Vol. 19, No. 1, 659, 11.09.2019.

    Research output: Contribution to journalArticle

    Mixon, AS, Smith, GR, Mallouk, M, Nieva, HR, Kripalani, S, Rennke, S, Chu, E, Sridharan, A, Dalal, A, Mueller, S, Williams, M, Wetterneck, T, Stein, JM, Stolldorf, D, Howell, E, Orav, J, Labonville, S, Levin, B, Yoon, C, Gresham, M, Goldstein, J, Platt, S, Nyenpan, C, Schnipper, JL, Sen, S, Badr, S, Murphy, M, Vasilopoulos, C, Vlasimsky, T, Roussel, C, Arole, O, Berescu, LD, Arifuddowla, A, Main, H, Pickle, S, Singleton, C, Asplund, B, Delrue, A, Forgione, A, Shipman, C, Brunetti, L, Ahmed, H, Gonzales, A, Molla, M, Bojerek, S, Nguyen, A, El-Kareh, R, Koenig, K, Succari, L, Kincaid, S, Proctor, P, Pendleton, R, Baughman, A, Boothe, K, Szablowski, K, Akande, O, Tichy, E, Zheng, C, Centafont, R, Jahrstorfer, R, Jaser, L, John, I, Curtin, M, Swindler, J, Marcus, J, Osten, R, Yaw, T, Al-Jammali, Z, Doherty, N, Hamilton, B, Hugais, M, Lee, S, Sabatini, P, Eabisa, E, Mello, J, Burton, J, Fink, E, Biondo, A, Huynh, T, Kormorny, K, Khoury, A, Ruf, K, Pierce, D, Lowther, C, Edholm, K, Mullin, S, Murphy, N, Norstrom, J, Driscoll, L, Cabie, M, Cadorette, A, John, S, D'Silva, A & Picot-Vierra, L 2019, 'Design of MARQUIS2: Study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation', BMC Health Services Research, vol. 19, no. 1, 659. https://doi.org/10.1186/s12913-019-4491-5
    Mixon, Amanda S. ; Smith, G. Randy ; Mallouk, Meghan ; Nieva, Harry Reyes ; Kripalani, Sunil ; Rennke, Stephanie ; Chu, Eugene ; Sridharan, Anirudh ; Dalal, Anuj ; Mueller, Stephanie ; Williams, Mark ; Wetterneck, Tosha ; Stein, Jason M. ; Stolldorf, Deonni ; Howell, Eric ; Orav, John ; Labonville, Stephanie ; Levin, Brian ; Yoon, Catherine ; Gresham, Marcus ; Goldstein, Jenna ; Platt, Sara ; Nyenpan, Christopher ; Schnipper, Jeffrey L. ; Sen, Sanchita ; Badr, Samer ; Murphy, Michelle ; Vasilopoulos, Corrie ; Vlasimsky, Tara ; Roussel, Christine ; Arole, Olugbenga ; Berescu, Loredana Diana ; Arifuddowla, Arif ; Main, Hattie ; Pickle, Susan ; Singleton, Cristy ; Asplund, Brenda ; Delrue, Andrea ; Forgione, Andrea ; Shipman, Colleen ; Brunetti, Luigi ; Ahmed, Hina ; Gonzales, Adrian ; Molla, Mithu ; Bojerek, Sarah ; Nguyen, Andrea ; El-Kareh, Robert ; Koenig, Kyle ; Succari, Loutfi ; Kincaid, Scott ; Proctor, Pamela ; Pendleton, Robert ; Baughman, Amy ; Boothe, Kimberly ; Szablowski, Katarzyna ; Akande, Olukemi ; Tichy, Eric ; Zheng, Chi ; Centafont, Ryan ; Jahrstorfer, Regina ; Jaser, Lisa ; John, Isha ; Curtin, Margaret ; Swindler, Jenna ; Marcus, Joe ; Osten, Robert ; Yaw, Tian ; Al-Jammali, Zainulabdeen ; Doherty, Nancy ; Hamilton, Brandi ; Hugais, Magdee ; Lee, Samson ; Sabatini, Paul ; Eabisa, Eddie ; Mello, Jennifer ; Burton, Julianna ; Fink, Edward ; Biondo, Anthony ; Huynh, Trina ; Kormorny, Ken ; Khoury, Adonice ; Ruf, Kathryn ; Pierce, Dwayne ; Lowther, Chadrick ; Edholm, Karli ; Mullin, Shantel ; Murphy, Nicole ; Norstrom, Jeni ; Driscoll, Laura ; Cabie, Maribeth ; Cadorette, Andrew ; John, Sara ; D'Silva, Amy ; Picot-Vierra, Lionel. / Design of MARQUIS2 : Study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation. In: BMC Health Services Research. 2019 ; Vol. 19, No. 1.
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    abstract = "Background: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. Methods: MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site's local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. Discussion: A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.",
    keywords = "Hospital medicine, Medication errors, Medication reconciliation, Patient safety, Quality improvement, Transitions in care",
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    TY - JOUR

    T1 - Design of MARQUIS2

    T2 - Study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation

    AU - Mixon, Amanda S.

    AU - Smith, G. Randy

    AU - Mallouk, Meghan

    AU - Nieva, Harry Reyes

    AU - Kripalani, Sunil

    AU - Rennke, Stephanie

    AU - Chu, Eugene

    AU - Sridharan, Anirudh

    AU - Dalal, Anuj

    AU - Mueller, Stephanie

    AU - Williams, Mark

    AU - Wetterneck, Tosha

    AU - Stein, Jason M.

    AU - Stolldorf, Deonni

    AU - Howell, Eric

    AU - Orav, John

    AU - Labonville, Stephanie

    AU - Levin, Brian

    AU - Yoon, Catherine

    AU - Gresham, Marcus

    AU - Goldstein, Jenna

    AU - Platt, Sara

    AU - Nyenpan, Christopher

    AU - Schnipper, Jeffrey L.

    AU - Sen, Sanchita

    AU - Badr, Samer

    AU - Murphy, Michelle

    AU - Vasilopoulos, Corrie

    AU - Vlasimsky, Tara

    AU - Roussel, Christine

    AU - Arole, Olugbenga

    AU - Berescu, Loredana Diana

    AU - Arifuddowla, Arif

    AU - Main, Hattie

    AU - Pickle, Susan

    AU - Singleton, Cristy

    AU - Asplund, Brenda

    AU - Delrue, Andrea

    AU - Forgione, Andrea

    AU - Shipman, Colleen

    AU - Brunetti, Luigi

    AU - Ahmed, Hina

    AU - Gonzales, Adrian

    AU - Molla, Mithu

    AU - Bojerek, Sarah

    AU - Nguyen, Andrea

    AU - El-Kareh, Robert

    AU - Koenig, Kyle

    AU - Succari, Loutfi

    AU - Kincaid, Scott

    AU - Proctor, Pamela

    AU - Pendleton, Robert

    AU - Baughman, Amy

    AU - Boothe, Kimberly

    AU - Szablowski, Katarzyna

    AU - Akande, Olukemi

    AU - Tichy, Eric

    AU - Zheng, Chi

    AU - Centafont, Ryan

    AU - Jahrstorfer, Regina

    AU - Jaser, Lisa

    AU - John, Isha

    AU - Curtin, Margaret

    AU - Swindler, Jenna

    AU - Marcus, Joe

    AU - Osten, Robert

    AU - Yaw, Tian

    AU - Al-Jammali, Zainulabdeen

    AU - Doherty, Nancy

    AU - Hamilton, Brandi

    AU - Hugais, Magdee

    AU - Lee, Samson

    AU - Sabatini, Paul

    AU - Eabisa, Eddie

    AU - Mello, Jennifer

    AU - Burton, Julianna

    AU - Fink, Edward

    AU - Biondo, Anthony

    AU - Huynh, Trina

    AU - Kormorny, Ken

    AU - Khoury, Adonice

    AU - Ruf, Kathryn

    AU - Pierce, Dwayne

    AU - Lowther, Chadrick

    AU - Edholm, Karli

    AU - Mullin, Shantel

    AU - Murphy, Nicole

    AU - Norstrom, Jeni

    AU - Driscoll, Laura

    AU - Cabie, Maribeth

    AU - Cadorette, Andrew

    AU - John, Sara

    AU - D'Silva, Amy

    AU - Picot-Vierra, Lionel

    PY - 2019/9/11

    Y1 - 2019/9/11

    N2 - Background: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. Methods: MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site's local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. Discussion: A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.

    AB - Background: The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. Methods: MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site's local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. Discussion: A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.

    KW - Hospital medicine

    KW - Medication errors

    KW - Medication reconciliation

    KW - Patient safety

    KW - Quality improvement

    KW - Transitions in care

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