Continuity of Medication Management

The Continuity of Medication Management (CMM) program is a component of the CEC Medication Safety and Quality Program.

It has been established to help improve the safe and quality use of medicines when patients transfer between and within health care settings. The focus of the CMM program is medication reconciliation and medication review.

When patients move between different health care settings, there is a risk of unintentional changes to their medicines. Unintentional changes include overlooking current medicines; starting medicines that are no longer taken, duplication of medicines, failure to restart medicines after surgery, transfer or discharge, and errors in recording medicines information, such as the incorrect drug or dose being prescribed.

These changes can lead to significant patient harm and less effective use of medicines.1 Around half of all hospital medication errors occur at admission or at discharge, with around 30 per cent of these errors having the potential to cause harm.2,3

Formalised medication reconciliation processes have been recognised internationally as a strategy to improve patient safety and the continuity of medication management.

References

  1. Commonwealth of Australia. (2005). Australian Pharmaceutical Advisory Council Guiding principles to achieve continuity in medication management. Canberra.
  2. Vira T, Colquhoun M & Etchells EE. (2006). Reconcilable differences: correcting medication errors at hospital admission and discharge. Quality Safety Health Care 15: 122-6.
  3. Cornish PL, Knowles SR, Marchesano R, Tam V, Shadowitz S, Juurlink DN & Etchells EE. (2005). Unintended medication discrepancies at the time of hospital admission. Arch Intern Med 165: 424-9.

When patients move between different health care settings there is an opportunity to ensure their medication regimen is safe and appropriate. A persons use of medicines may change over time, especially during an admission to a health service.

A structured review of a patient's current (existing and newly prescribed) medicines aims to minimise medicine-related problems and optimise therapeutic outcomes. This is achieved by partnering with patients to assess if current medicines are still required, if medicines use is evidence based, if medicines are working as intended and if there are any barriers to medicines use such as adverse effects, cost or other patient or disease specific issues.

The program also provides resources and support for local health districts (LHDs), speciality health networks (SHNs) and individual hospitals to meet the National Safety and Quality Health Service (NSQHS) Standards.

The Medication Reconciliation Toolkit provides information, resources and quality improvement (QI) tools to support health services with their medication reconciliation efforts.

As medication reconciliation processes vary across health services, resources may be adapted to suit local needs i.e. for initial implementation, to review and improve current practices, or support current activity.

This module is available through the Health Education and Training Institute (HETI) (course code: 157075702). It is available for NSW Health staff and qualifies for up to 0.5hrs of Continuing Professional Development (CPD) points.

Our CMM Expert Advisory Group (CMMEAG) provides expert guidance and strategic direction to the CMM program, ensuring it best meets the needs of our health services.

The CMMEAG meets twice a year and mainly focuses on medication reconciliation and medication review.

CMMEAG enquiries

Australian

International

Acknowledgements

The Clinical Excellence Commission acknowledges the contribution of the Continuity of Medication Management Expert Advisory Group, Medication Reconciliation Leads, and colleagues across LHDs, SHNs and individual hospitals in the development of the CMM related resources.