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5 questions to ask about your medication

Engaging patients and family members in a conversation about medication safety, helping them be an active partner in their health. 

The problem

Patients are the constant in every transition of care, sometimes they are then asked to be the conduit of medication information from one provider to the next without necessarily being equipped to do so. Patients can find it overwhelming to know the right questions to ask especially at transitions of care, where the risk of medication error is high.Read the patient story that sparked the idea: http://www.uhn.ca/corporate/News/Pages/five_questions_to_ask_about_your_medications.aspx    

Aims

ISMP Canada, the Canadian Patient Safety Institute, Patients for Patient Safety Canada, the Canadian Pharmacists Association and the Canadian Society for Hospital Pharmacists have collaborated to develop a set of 5 questions to help patients and caregivers start a conversation about medications to improve communications with their health care provider.In 2014, we had held a National Medication Safety Summit to accelerate the work to improve medication safety in Canada. Within the discussion, the idea of the national medication checklist came about:http://www.patientsafetyinstitute.ca/en/About/PatientSafetyForwardWith4/Documents/A%20Medication%20Safety%20Action%20Plan.pdf#search=summit

Making the case for change

We communicated the need for change to patients and health care providers through our YouTube video and we involved patients and health care providers in the development and dissemination of the tool. Over 100 organizations across all sectors of care have endorsed the tool and it is available in over 20 languages. https://www.ismp-canada.org/medrec/5questions.htm#l=tab3    

Your improvement

We started the work with a small advisory group, and then tested the tool locally, improved it and then launched it nationally. We were able to test the tool across different sectors of care and make modifications using the PDSA cycle, based on the feedback we received from the electronic surveys we sent out.  When we created our first draft, we had three full pages of questions and things for patients to do. The feedback from patients told us that was too much information. We continued to revise and improve the set of questions based on feedback from patients and healthcare providers. We have tested it in various sectors: primary care, acute care, home care, long term care with different professionals - nurses, nurse practitioners, doctors and pharmacists and used their feedback to make it better.  We continue to receive feedback on the tool.

Learning and next steps

Our greatest challenge was to narrow the focus of our questions and to keep it simple. We wanted to make it as patient friendly as possible and we did that by including patients as part of our advisory group from the very beginning and listened to their feedback. The next step is to create patient friendly tools to help facilitate the answering of these questions, specifically with respect to opioids. 

Quality assurance/MHRA Registration

Endorsement by over 100 organizations in Canada, including the Accreditation body in Canada. It was also introduced internationally at the 69th World Health Assembly Side Event "Addressing the Global Challenge of Medication Safety to Improve Patient Safety and Quality of Care" in May 2017. https://www.ismp-canada.org/medrec/5questions.htm#l=tab2