At least 1.5 million Americans are injured every year through medication errors, adding billions of dollars to the cost of health care. Determining which medications a patient is taking prior to admission, which are given during a hospital stay, and which are prescribed when they are dischargedâ€”and making sure that none of these interact with unintended consequencesâ€”is a vital process called medication reconciliation. In understaffed hospitals, it’s a process that is full of potentially lethal challenges.
Streamlining this process was the goal of an interdisciplinary competition hosted by the Texas A&M Health Science Center and Texas A&M University in the spring 2010 semester. Mays finance students Rawles Bell ’11, Frederick Lou ’11, Sarah Mullis “10, and Ryan O’Dwyer ’11 teamed with students from industrial engineering, nursing, and pharmacy programs at A&M evaluating medical reconciliation practices at local hospitals and providing practical solutions for improvement.
It was more than a learning exercise: solutions have been implemented in hospitalsâ€”where they are potentially saving lives.
Each team was paired with a small hospital to collect data and solicit input from its personnel on effective medication reconciliation. Faculty advisors coached and mentored the teams throughout the process. The initial meetings and hospital visits occurred in late January, with a mid-semester progress review in March.
At the end of the semester, each team delivered their solutions before a panel of judges from various medical professions, including doctors, pharmacists and hospital administrators. The team also prepared a final report for its respective hospital and a poster.
Competition winner Frederick Lou says that his team’s biggest challenge in working with the Grimes St. Joseph Health Center in Navasota was a lack of education and enforcement surrounding existing medical reconciliation practices among the hospital staff. Also, the hospital had limited funds, so whatever solution they devised must be inexpensive.
Lou and teammates created a new policy stipulating no new medicines could be prescribed until a current medicine list had been completed on new patients. They also created an education plan to increase awareness of the policy for staff, and implemented an electronic data collection system as a way to track progress.
Second-place finishers Sarah Mullis and teammates worked with Richards Memorial Hospital, a 25-bed facility in Rockdale, Texas. Over the course of several visits to the hospital, the team examined the medical reconciliation process, which involved a photocopied form that was filled in by several members of the medical staff for each patient from admission to discharge. Mullis’ team created a new, easier-to-use form that incorporates information from the computer program used by the hospital pharmacist. They created a new policy for use of the form, as well, including digital copies and doctor’s signatures.
Prior to the competition, “I didn’t know anything about medical technology,” said Mullis. Her biggest takeaway was learning how to approach a complex problem while working with a team comprised of people with varying expertise.
Competition participants received prize money and class credit, as well as valuable experience. “It was great to see that something we were working on was making a difference,” she said.
Based out of the Texas A&M Health Science Center Rural and Community Health Institute, competition coordinators were Kathy Mechler and Robert Morrow of the institute; and Sara McComb and Andy Banerjee of the Texas A&M Dwight Look College of Engineering.
Funding for the student competition was provided through an HSC grant with the Annenberg Foundation. Faculty team leaders were Kathryn Cochran and Regina Bentley of the HSC-College of Nursing; Robert Stanberry of the HSC-College of Pharmacy; Justin T. Yates of the Texas A&M Dwight Look College of Engineering; and Christopher J. Duzich of Mays Business School.