Inter-facility communication barriers delay resolving medication discrepancies during transitions of care

Abstract

Background: Medication discrepancies occurring during transitions of care between hospitals and nursing homes increase the risk of adverse events for patients. Resolving mismatched information between hospitals and nursing homes adds additional burden to nursing home staff.

Objective: The aim of this study was to characterize challenges facing nursing home staff in receiving and resolving medication discrepancies during resident intake.

Methods: This study used one focus group comprised of five nurses, one pharmacist and two administrators from four nursing homes to explore the staffs' experiences resolving medication discrepancies at resident intake. Thematic analysis was used to determine primary themes and categories arising from focus group transcripts.

Results: Three common challenges included 1) Nursing homes relying upon external providers for accurate information that is frequently delayed; 2) Prescribing data shared between hospitals and nursing facilities on incompatible formats with inconsistent content; 3) Following a specific communication workflow between facilities to resolve errors as efficiently as possible.

Conclusions: Improving access to formularies and medical histories for providers across the continuum of care and improving information sharing across transitions would improve communication, decrease discrepancies and increase patient safety during post-acute care transitions.

Keywords: Communication; Long-term care; Medication reconciliation; Qualitative research; Transitions of care.