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• Kelowna General Hospital
• Renal Pharmacy
• Collaboration
• Pharmacist Managed MedRec and Care of End Stage
  Renal Disease in Patients

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Background

• Patients with end-stage renal disease (ESRD) are
  at high risk for drug-related problems (DRPs),as
  these individuals take numerous drugs, have
  multiple co-morbidities, and experience frequent
  medication changes
• The project will target patients with end stage
  renal disease (on dialysis) who are admitted to
  Kelowna General Hospital acute care during the 6
  month pilot project duration.
• Hospitalization of patients with ESRD can
  contribute to the risk of DRPs.
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Background

• Medication reconciliation is part of a broad
  process of pharmaceutical care, which is the
  collection of relevant drug, disease, and patient
  information through a chart review and interview
  with the patient and/or family members and
  healthcare providers, followed by an
  interpretation of all available information to
  identify, characterize, and resolve the patients
  actual and potential DRPs.
• The project will enable a multidisciplinary team
  to develop appropriate tools and an efficient
  process for a medication reconciliation and
  pharmaceutical care service in the ESRD inpatient
  population.
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Background

• The project will also help to identify the system
  problems, characterize the incidence, type, and
  timing of discrepancies and DRPs (and their
  associated medications) throughout the entire
  hospital stay.
• Furthermore, having this preliminary pilot data
  may increase the political will to allocate
  adequate resources to expand clinical pharmacy
  services to the renal (or other) areas throughout
  IHA.
• Expected start date is dependant on securing
  funding for the project
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Objectives

• The purpose of this pilot project is to develop a
  pharmacist-managed medication reconciliation and
  pharmaceutical care service in the ESRD inpatient
  population to identify, characterize, and resolve
  medication discrepancies and DRPs, and collect
  preliminary information on drug acquisition cost
  changes and pharmacist time requirements to
  perform this activity.
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Goals

• To collect pertinent baseline information on the
  incidence and type of medication discrepancies
  and DRPs
• To develop useful tools and an efficient process
  for the provision of medication reconciliation
  and pharmaceutical care
• To identify, characterize, and resolve
  unintentional and undocumented intentional
  medication discrepancies, and calculate the
  medication reconciliation success index
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Goals

• To assess the potential impact and relationship
  to gaps in the medication information transfer
  process of unintentional and undocumented
  intentional medication discrepancies and DRPs
• To determine the number, type, and medications
  associated with identified DRPs
• To determine the acquisition medication cost
  impact of medication reconciliation and
  pharmaceutical care
• To determine and characterize the time required
  for a pharmacist to perform medication
  reconciliation and pharmaceutical care.
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Team Members

• Dr. Gerry Karr, Richard Slavik,
• Sue Bannerman, Cathy Farrow,
• Paul Filiatrault, Susan Haskett,
• Sean Hickey, Wrae Hill,
• Holly Morgan, Christina Krause,
• Norma Malanowich, Gordon McGreevy,
• Kevin Peters
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Team in Developmental Stage

• We have submitted our project proposal for
  funding
• We have written our MedRec charter
• We have started process mapping of an acute care
  episode for chronic renal patients
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Next Steps

• Obtain funding for project
• Finish process mapping
• Initiate project
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Process Map
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Contact Information

• Sue Bannerman
• Lead, Renal Program
• Interior Health Authority
• 210 - 1815 Kirschner Road 
• Kelowna, BC   V1Y 4N7
• Phone  [phone] Fax  [phone]
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Med Rec Charter