Hospitals face new reconciliation, anticoagulation goals

Even as hospital pharmacists are struggling to meet previous mandates, the Joint Commission has released 2009 National Patient Safety Goals-including revisions to medication reconciliation and anticoagulation standards-that may prove burdensome for some practitioners.

The new requirements include the implementation of practices to prevent hospital-acquired infections due to multiple drug-resistant organisms. Full implementation of the requirements is expected by the beginning of 2010. Other significant changes involving pharmacists are revisions to the medication reconciliation and anticoagulation standards. "The way the new goals are stated, they give pharmacists better guidance," Bona Benjamin, B.S. Pharm., director, medication-use quality improvement at the American Society of Health-System Pharmacists, said. But "many pharmacists are still struggling with [the 2008] goals. We all agree that it's a good thing to do. There are changes that are complex."

Benjamin said ASHP was pleased to see suggested revisions included in the 2009 goals concerning drug reconciliation lists. "Only the most current [medication] list is the most important," she said.

Hospitals are also grappling with the anticoagulation requirements. Pennsylvania-based Geisinger Health System established a system-wide team to review its current anticoagulation processes. It created a team that included clinical pharmacists, medical staff, and nurses. Dean Parry, R.Ph., director, clinical programs at Geisinger, said the hospital used "numerous resources" to identify risk areas. The team's analysis led to process changes designed to reduce risk. Parry said the changes included the development of a pharmacy-run inpatient anticoagulation management program.