Analysis of the best possible medication history (BPMH) collected at a tertiary care hospial

Purpose: The Best Possible Medication History is a process to obtain the most accurate medication list, used to decrease the incidence of discrepancies and eliminate the risk of unintentional harm. At Allegheny General Hospital, the BPMH process is being expanded with a target capture rate of 100% of admitted patients. For this project, we are implementing documentation and assessment process to measure the workload volume and effectiveness of the AGH BPMH program. Methods: The BPMH Documentation includes the patients’ day of admission, the nursing unit, the date the BPMH was conducted, and the time to conduct the evaluation. This documentation is used for a retrospective chart review of patients who were admitted to AGH during a two week period. Pharmacy intervention documentation reports were used to calculate the hospital capture rate, unit specific capture rate, average time spent on BPMH, average time between admissions and conducting the BPMH, and the total number of discrepancies involving high risk medications. Results: 423 patients were identified with admission completed BPMH. The capture rate at AGH was defined as 50.3%. The nursing unit with the highest pharmacy completed BPMH was the observation unit with 96 BPMHs. A total of 404 BPMH were completed within 48 hours after admission, representing 85.6% of all BPMHs, a median of 0 days with an IQR [0,1]. The median time to conduct the BPMH was 20 minutes with an IQR [10, 25]. Conclusion: This evaluation has shown a need at AGH for BPMH specific pharmacy staff that can increase the capture rate around the hospital and on specific nursing unit. Taking in consideration some limiting factors, it is important for any employee to properly document their work, which helps with the accuracy of the BPMH evaluation tool. Public Health Significance: One of the most effective public health techniques is prevention and optimization of medical care. Maximizing the capture rate around the hospital can prevent any inpatient prescription errors, which will in turn prevent any medication caused adverse effects. This can contribute to the wellbeing of the community AGH serves and the overall safety of the admitted patients.