Customer: Marshall Medical Centers
Problem / Challenge: Marshall Medical Centers wanted to improve the medication reconciliation process to provide a more complete/correct record of a patient’s home medications
Proposed Solution: Establish a lean improvement team to engage physicians across the two-hospital system with the focus on system level standardization and process improvement

Methodology and Outcomes:

Team & Training: The hospital assembled a cross-functional team of nurses, doctors, administration, and engineers. The team then participated in lean healthcare and value stream mapping overview training from UAH Lean Healthcare practitioners. 

lean healthcare mmc medrec
Mapping: The team decided to focus improvement efforts on the front end of the process, as it would have a positive impact on the steps downstream. The team mapped the front end data collection step in higher detail and looked for waste. Once the waste was identified, the team envisioned their ideal state and brainstormed improvements to help achieve it

Standard Procedure: The team developed a standard operating procedure in the form of a checklist. This checklist, if followed correctly, ensures that all of the data sources are used. At the same time, the checklist standardizes the med rec process for all nursing staff. After the checklist showed improvement, the team decided to add the concept of verification levels. Verification levels correspond to the number of data sources on which the medication appears. These levels help doctors make decisions and mitigate risk when prescribing medications.

With the standard checklist in place,
• The total errors dropped by 60%
• The variance reduced by over half
• The percentage of patients with errors on their home med sheets reduced by 34%.