3. Engagement with Nova Scotians

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Outpatient renal team and patients working together to ensure medication safety

Roland Lavoie

Margaret Angus

Roland (Smokey) Lavoie keeps a spreadsheet of his medications on his home computer.

He talks with his pharmacist, doctors and other health professionals when anything changes.

As someone undergoing dialysis, he knows how important it is to track dosages and timing to prevent adverse reactions. That’s why Lavoie is so supportive of the renal team’s work to partner with patients on medication reconciliation.

Medication reconciliation is a process whereby health professionals work with patients, using many sources of information, to gather the patient’s best possible medication history. This helps them identify and correct discrepancies, as well as communicate this information to the patient and other health professionals.

Accreditation Canada recognized the renal team’s work with ambulatory medication reconciliation with leading practice this year. This prestigious national designation is awarded to health and/or social service organizations for demonstrating innovative, effective and positive change.

“Back in 2013, it was identified that medication reconciliation was non-existent in ambulatory (outpatient) care,” renal pharmacist coordinator in nephrology Dr. Jo-Anne Wilson said.

“Our patients are incredibly high-risk for experiencing medication errors,” Dr. Wilson explained.

“They’re often on 12 or more medications and they’re cared for by many health professionals. In patients undergoing dialysis, nearly 30 per cent of medication discrepancies can be associated with moderate to severe adverse outcomes.”

Driven by the need to reduce this risk, the team developed a new medication reconciliation form and process to capture and share the patient’s most thorough medication history.

Patients were an important part of this process, providing feedback along the way.

“One of the things patients advocated for is that we give a copy of the form to their family physician and community pharmacist,” Dr. Wilson said.

The team also surveyed community practitioners to solicit their views about receiving the forms.

“If medication discrepancies are identified, it’s an opportunity to reach out to those who are managing medications to ensure things are as they are supposed to be,” she said.

As a patient, Lavoie feels reassured by the team’s focus on capturing an accurate record of medications.

“It’s so good that they review it on a regular basis,” he said.

As a patient, he’ll continue to be vigilant, too, and he encourages other patients to do the same. “It’s important to report anything that’s going on.”

While this process and form were developed by and for the renal program, the work has been shared extensively across Nova Scotia Health Authority (NSHA). Lavoie and patients like him are helping to keep medication safety at the forefront.