Reconciling Patients’ Medications: Safe Practice Recommendations

Posted on Friday, August 19, 2016 8:30 PM

The best plan to avoid re-hospitalizations and stiff fines for inaccurate or incomplete documentation is effective communication between the clinicians and the physicians. The problem: Agencies don’t understand all the steps CMS requires in a drug review, says Ann Rambusch, president of Rambusch3 Consulting in Georgetown, Texas.

She says clinicians often will identify an issue with the patient’s medication, fax the issue to the physician and think they job is done. But it is not. The physician has to be contacted and the problem resolved.

Home health agencies do a poor job of reconciling patient medications, agrees Arlene Maxim of A.D. Maxim Consulting in Troy, Mich.

OASIS item M2000 (Drug Regimen Review) requires agencies to document all prescription and over-the-counter medications and to specify “potentially significant medication issues such as adverse drug reactions or ineffective therapy, side effects, drug interactions, duplicate therapy, dosage errors or noncompliance.”

Medication lists are notorious for being duplicative or incorrect, Maxim says. “It happens all the time.”

Patients come from the hospital with a prescription for a medication they are already taking — one using the brand name and the other the generic moniker, Rambusch says.

A patient’s medication list should be entered into software that identifies duplication in or potential interactions, she says.

“There is great software available — some built into [the agency’s] EMR,” Rambusch says.

Tips for performing medication reviews: 
• Make sure clinicians don’t only perform drug reviews on admission or at the start of care
• Implement an “ABC” policy — Always Bottle Check
• Ask patients if they have had an emergency room visit since the last time you saw them

For the full article, please see the August 22, 2016 Home Health Line Edition.

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