Maple Grove Hospital understands the importance of moving from good practices to “always” – not just for the impact on HCAHPS scores, but for the consistently great experiences that hardwired practices create for patients. With regard to medication, Maple Grove, like many hospitals, found that while they scored well on the question, “Before giving you any new medicine, how often did hospital staff tell you what the medicine was for?” However, their scores lagged for the question, “Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?”
Knowing that caregivers were doing their best to convey side effects information consistently and in a memorable way, Maple Grove looked for a way to remove the barriers and help bedside nurses provide the most accurate information possible. “We cannot expect the bedside nurse to memorize the side effects of every medication or look them up every time a medication is administered” said Sarah Johnson, Director of Clinical Support and one of the medication communication improvement project leaders.
Working with the Clinical Informatics Committee and IT Governance, the Medication Communication Committee embedded a new process into the system EHR whereby every 48 hours a medication is scanned for administration, an alert appears with a prompt that contains the drug name, medication indication, and the most common side effects associated with the given therapeutic class of medication. In total, over 30 classes of medications are included, with side effect information developed by the MGH pharmacy based on the medication’s therapeutic class. Patients who request additional information on the medication receive a handout of complete medication information printed from the EHR. If patients have additional questions, nursing staff contact a pharmacist who can answer patient questions or provide the patient with further information.
The alert went live the beginning of November 2013. Feedback from nurses so far is extremely positive. “This is not about chasing HCAHPS scores,” said Linnea Huinker, Senior Clinical Effectiveness Specialist. “It’s about patient and family engagement in understanding the importance of why and how they take their medications. If they don’t say we always do this, we know we can do better.”
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