Presentation
HE14 - Medication Reconciliation in the Emergency Department: Work-As-Done vs. Work-As-Imagined (Policies and Protocol)
SessionPoster Session 1
DescriptionMedication reconciliation, the process of ensuring accurate and complete medication information transfer, is critical for preventing medication errors during care transitions, particularly in the high-risk and fast-paced environment of an Emergency Department (ED). While there are policies and protocols in place, adherence can be challenging at times and may lead to medication-related incidents. This study aims to examine the discrepancies between the written policies and procedures (Work-as-Imagined) and the actual medication reconciliation practices (Work-as-Done) in the Emergency Department of Erie County Medical Center (ECMC) in Western New York. Understanding these deviations is key to developing targeted interventions that can enhance adherence to protocols and improve overall patient safety.
The Functional Resonance Analysis Method (FRAM) provides the framework for analyzing our data, which includes field observations of the medication reconciliation process in the studied ED, contextual inquiries of ED pharmacists and nurses about their medication reconciliation work, and the relevant policy and procedural documents provided by the participating hospital. FRAM is applied for its strength and flexibility in modeling complex socio-technical systems, enabling a detailed comparison between Work-as-Imagined and Work-as-Done to explore how work adaptations happen and how they affect overall system performance in dynamic healthcare environments.
Our initial findings have revealed notable differences between actual practices and subscribed procedures of medication reconciliation in the ED, highlighting important factors such as communication barriers between different clinical roles, operational and time constraints, and the need for flexibility in following protocols. Deeper insights from the FRAM models will help guide the development of targeted interventions aimed at aligning daily practices with established procedures to enhance patient safety in the ED.
The Functional Resonance Analysis Method (FRAM) provides the framework for analyzing our data, which includes field observations of the medication reconciliation process in the studied ED, contextual inquiries of ED pharmacists and nurses about their medication reconciliation work, and the relevant policy and procedural documents provided by the participating hospital. FRAM is applied for its strength and flexibility in modeling complex socio-technical systems, enabling a detailed comparison between Work-as-Imagined and Work-as-Done to explore how work adaptations happen and how they affect overall system performance in dynamic healthcare environments.
Our initial findings have revealed notable differences between actual practices and subscribed procedures of medication reconciliation in the ED, highlighting important factors such as communication barriers between different clinical roles, operational and time constraints, and the need for flexibility in following protocols. Deeper insights from the FRAM models will help guide the development of targeted interventions aimed at aligning daily practices with established procedures to enhance patient safety in the ED.
Event Type
Poster Presentation
TimeMonday, March 314:45pm - 6:15pm EDT
LocationFrontenac Foyer
Digital Health (DH)
Simulation and Education (SE)
Hospital Environments (HE)
Medical and Drug Delivery Devices (MDD)
Patient Safety and Research Initiatives (PS)