New Tools To Improve Patient Safety During Transitions Of Care

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National Transitions of Care Coalition (NTOCC) Advisory Task Force authorized the release of recently developed tools for helping healthcare professionals and organizations address problems inherent in transitioning patients from one level of care to another. The tools represent the culmination of several months of collaboration between 29 industry stakeholders who joined together in 2006 to address challenges associated with transitions of care. In addition, NTOCC is also releasing accompanying information on how to implement and measure the tools as well as material designed to raise industry, policy maker, media and the general public's awareness of transitions of care.

"The amount of work this group has accomplished in just 18 months is impressive," Cheri Lattimer, NTOCC Project Director and CMSA Executive Director said. "For a group this large, representing such various points of view within healthcare, to come together and not only agree that transitions of care is a serious problem but also design, develop and launch tools to impact this issue is a fantastic accomplishment."

Included with the launch of the tools is a "Case Study Implementation and Evaluation Plan" on how healthcare providers can implement them within their clinical environments as well as a process for evaluating and measuring their effectiveness. "Providers can use the tools and process to start making changes in how transitions occur within their facilities," H. Edward Davidson, PharmD, MPH and the representative of the American Society of Consultant Pharmacists (ASCP) said. "The goal is that providers are empowered to take the first step at measuring their own performances in transitions of care and identify areas for improvement. These areas include such things as improving how medication changes are reconciled when patients move from a nursing home to a hospital, through the hospital, and through the discharge process." The materials include an educational component about transitions of care, an implementation case study and evaluation methodology.

The released tools address several important areas that impact effective and safe transitions including:

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-- Personal Patient "My Medicine List" Essential Data Elements: This is a list of medications to be carried at all times by every patient. The data elements indicate the prescriptions that patients have been prescribed and are currently taking along with information about their over-the-counter medications, vitamins, and nutritional supplements. The goal of the personal medicine list is to help patients improve their understanding of their current medicine regimens and assist healthcare providers in ensuring safe transference of medication information.

-- Medication Reconciliation Essential Data Specifications: These consensus elements will help healthcare professionals collect, transmit and receive critical medication information needed when patients move from one practice setting or level of care to another. The use of these elements in the reconciliation process required by the Joint Commission could help reduce medication errors.

-- Elements of Excellence Transitions of Care Checklist: This list provides a detailed description of effective patient transfer between practice settings. This process can help to ensure that patients and their critical medical information are transferred safely, timely, and efficiently.

In addition, NTOCC authorized the release of materials that will help the industry, consumers, government officials and regulators better understand the problems inherent in transitions of care and recommendations on how to create better transitions. This material includes an awareness slide deck as well as a detailed concept paper outlining steps to be considered by the healthcare industry and policy makers to improve transition performance.

Transitions of care include situations in which a patient moves from primary care to specialty physicians or moves within the hospital including moves from the emergency department to other various departments, such as surgery or intensive care; or when a patient is discharged from the hospital and goes home or to an assisted living, skilled nursing facility, or hospice. Patients, especially older persons, face significant challenges when moving from one level of care or practice setting to another in the healthcare system. During these transitions, lack of communication can result in redundant or conflicting information that often creates serious issues for patients, their caregivers and their families.

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