This document summarizes a national call on October 1st, 2013 about a Canadian MedRec Quality Audit. It includes an overview of the audit tool and experiences using the tool from two organizations. The Winnipeg Regional Health Authority audited admission medication reconciliation processes at Churchill Health Centre and found opportunities for improvement around collecting medication histories and documenting rationales for medication changes. Interior Health in British Columbia also used the audit tool and found that medication histories were usually based on more than one information source but rationales could be documented more consistently. The call promoted a Canadian MedRec Quality Audit Month in October for healthcare organizations to use the audit tool to measure and improve admission medication reconciliation.

1. Canadian MedRec Quality Audit
National Call
October 1st, 2013
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2. Welcome to our francophone
attendees
Bienvenue à nos participants
francophones
Hélène Riverin
Conseillère en sécurité et en amélioration
Safety Improvement Advisor
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3. Overview
• Brief review of the MedRec quality audit
tool
• Share the experience of two organizations
who have used the audit tool
• Describe the Canadian MedRec Quality
Audit Month
• Respond to Questions
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4. Please complete our poll
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5. Highlights of the MedRec Quality
Audit Tool
Jennifer Turple
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6. MedRec Quality Assessment DCF
6
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7. June 2013 Webinar/National Call
A Novel Tool to Assess the Quality of
Admission MedRec Processes
Jennifer Turple
ISMP Canada
Alex Titeu
Safer Healthcare Now! Central Measurement
(Patient Safety Metrics)
http://www.saferhealthcarenow.ca/EN/events/NationalCalls/2013/Pages/A-Novel-Tool-toAssess-the-Quality-of-Admission-MedRec-Processes.aspx
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8. Why focus on Admission?
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9. Presence of an Admission
MedRec /BPMH
form on chart
Are the processes “behind
the form” of good quality?
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10. How often are we doing
everything as intended?
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11. Selected Audit Tool Questions
• Was MedRec performed?
• Was the BPMH collected using more than 1 medication
information source?
• Was there a patient or caregiver interview to verify actual
medication use?
• Has every medication, as listed in the BPMH, been accounted
for in the admission documentation? (i.e. are there any
outstanding differences/discrepancies despite the MedRec
process?)
• Where differences between the admission documentation
and the BPMH exist, were these differences resolved?
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12. MedRec Audit Experiences
“from the field”
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13. My Experience with
the MedRec
Quality Audit Tool
October 1, 2013
Béatrice Patton
Patient Safety Pharmacist
WRHA Quality and Patient Safety
Winnipeg Regional Health Authority
13

14. Winnipeg Health Region
Churchill Health Centre

15. Current WRHA MedRec audit tools
Form #1
Compliance
Form #2
Overall quality
of completeness
Collating results
manually

16. Future WRHA MedRec audit tool
What is not to like?
 ONE reporting form
 Easy to use/complete
 Simple to submit
 Focuses on the QUALITY of
admission MedRec processes
 Collated results available within
minutes in system!
 Automated reports accessible to
sites/organization

17. The Raw Data

18. The Quality Measures

19. The Score

20. Expected results
Actual results
60-80% compliance with
MedRec admission form
All pre-admission patients
interviewed for medication use
At least 1 info source used (most
commonly DPIN)
100% of patients audited had a
completed form in chart
7/10 patients had a medication
history taken with patient
6/7 who had a pt interview, also
had one other info source
Missing components in in
medication information
Not all meds reconciled (ie.
decision box not checked off)
>75 % rationale for holding
Each medication was complete!
All meds were assessed/
reconciled!
2/10 patients had a rationale
provided
100% “reconciled”/completed at only 1/10 met perfect QA score admission
deficiencies in process!

21. The Next Steps
Plan for improvement:
 Pre-admission clinic:
 Use one information source along with patient interview
 Indicate “unable to perform” on form when patients
unreliable/unable (need section on form)
 Surgeons/HMOs
 Communicate importance of indicating rationale for
holding/discontinuing
Share and celebrate results with the orthopedic team:
 Great job in completing the MedRec admission form
(completeness of medication information, capturing
information source, reconciliation)

22. Interior Health
Interior Health Quality Audit
Med Rec
Geoff Schierbeck
Quality Consultant
Interior Health
Geoff.schierbeck@interiorhealth.ca
Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia.

23. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

24. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

25. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

26. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

27. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

28. Interior Health Authority
Is the BPMH based on greater than
1 source?
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

29. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

30. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

31. Interior Health Authority
Our Vision: To set new standards of excellence in the delivery of health services in the Province of British Columbia

32. MedRec Quality Audit Month
•
During the month of October, we are challenging all acute and
long-term care organizations to audit their established processes
for MedRec at admission.
•
Auditing the process will help to identify areas of excellence and
areas for improvements. Measurement is critical in the journey to
improve the delivery of safe and effective care for patients.
•
The purpose of the Canadian MedRec Audit Month is to
encourage acute care and long term care organizations to:
•
Qualify and quantify how they are performing the basics
tenets of the admission MedRec process,
•
Use the Canadian MedRec Audit data collection/audit tool
to inform admission MedRec process improvements,
•
Use Patient Safety Metrics System* to view and analyze
collated results.
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33. October is MedRec Quality Audit Month!
Want to participate?
HERE’s HOW….
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34. STEP 
Determine your eligibility
to use this audit tool.
You should:
1- Have an implemented ADMISSION MedRec
process and
2- Have a MedRec process follows an Acute
Care OR Long Term Care model.
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35. STEP 
Consider which care areas you would like to
audit and how you might wish to
group/analyze the audit results.
For example, would you like to collect and
analyze audit data from multiple units?,
across multiple sites?, across a region?
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36. MedRec Quality Assessment DCF
36
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37. STEP 
Register/Enroll to participate in Canadian
MedRec Quality Audit Month.
Free to participate, by registering you are committing
auditing your admission MedRec process during the
month of October.
https://secure.e-registernow.com/cgibin/mkpayment.cgi?MID=1527&state=step2direct&e
vent=500000274139982
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38. Registration
The
information
entered here
allows the
Patient Safety
Metrics team
to help build
your area
specific data
collection
forms/audit
tool
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39. STEP 
Access your audit tool
Either you can:
• Receive your audit tool from the Patient
Safety Metrics team via email
OR
• Generate your tool yourself, via the Patient
Safety Metrics System
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40. Generating Audit Tool/Data Collection
Form
1.
Login into Patient Safety Metrics site:
https://shn.med.utoronto.ca/metrics/Login.aspx
2. Select the Data tab
3. Select the Intervention for which you wish to add
Either by selecting the intervention from the list or selecting the
intervention from the intervention tab
4.
Click the Add new Data Collection Form button
5.
Select the Survey from the drop-down menu, along with any
applicable attributes such as In/Out, Adult/Paediatrics, Age
Group, Program, Service, Unit/Site, Procedure, or Patient
Sample.
Please fill-out all as much information as possible. This will allow for
better data roll-up and drill-down for reporting.
6.
Click the Save button to add the new data collection form.
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41. STEP 
Choose a sampling approach
The number of charts you audit and the method
you choose to select patients for auditing is
up to the end user.
We would suggest a minimum of 10-20 charts be audited, and that these
charts be randomly selected.
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42. STEP 
Complete the audit
Follow the guidance for completion of the tool as
provided on the June 18th, 2013 webinar:
http://www.saferhealthcarenow.ca/EN/events/Nation
alCalls/2013/Pages/A-Novel-Tool-to-Assess-theQuality-of-Admission-MedRec-Processes.aspx
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43. STEP 
Submit your results (via fax) to the patient
safety metrics system
Using a high resolution setting, fax your audit
tool to the number found on bottom of the
audit tool
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44. Questions?
44
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45. 3 ways to ask a question via Webex
 Under participants panel,
raise your hand by clicking on the hand icon.
If you have a phone icon beside your name
we can unmute your line enabling you to
ask your question “live”
Type your question in the chat
box, select “all participants” from
the drop down and click “send”
Type your question in the “Q &
A” box
45
All Participants
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46. We are here to help!
Key Contacts:
ISMP Canada MedRec Team
medrec@ismp-canada.org
www.ismp-canada.org/medrec
CPSI Central Measurement Team
metrics@saferhealthcarenow.ca
Virginia Flintoft - 416-946-8350
Alexandru Titeu - 416-946-3103
Key Links:
Patient Safety Metrics System: https://shn.med.utoronto.ca/metrics/Login.aspx
June 18th Audit Tool Call Slides/Recording: http://tinyurl.com/puxq8cj
Registration Page for MedRec Audit Month: http://tinyurl.com/pox49bf
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47. Please complete our poll
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48. October 28th -November 1st, 2013.
October 30th Theme: Medication Safety: Across the Continuum
Program Includes:
•Implementing Med Rec Successfully. The New Paper to Electronic Toolkit
12:15 pm MT / 2:15 pm ET
Dr. Andre Kushnirik, Professor, School of Health Information Science, University of Victoria; Adjunct Associate
Professor, University of Toronto Faculty of Medicine and the Mt. Sinai School of Medicine, New York
•Engaging Consumers in Medication Safety: Results of three years of consumer error
reporting program and planned plain language labeling project
11:00 am MT / 1:00 pm ET
Lynn Riley, Medication Safety Specialist and Educator, Institute for Safe Medication Practices Canada (ISMP Canada)
•The Canadian MedRec Admission Quality Audit Results
12:40 pm MT / 2:40 pm ET
Hugh McLeod, CEO, Canadian Patient Safety Institute
Full details available at:
http://www.patientsafetyinstitute.ca/english/news/canadasforumpatientsafety/pages/defa
ult.aspx
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