National Symposium on Medication Management

Communication is a Common Concern.

Last week I had the honor of serving as a moderator and speaker at the Center for Excellence in Assisted Living (CEAL) Medication Management in Assisted Living Symposium in Washington, D.C. The aim of the symposium was to “catalyze discussion and examination on the safety and quality of medication management” with a focus on three key areas directly affecting assisted living providers and our residents:

  1. Prescribing of medication
  2. Dispensing of medication
  3. Administering/documenting medications

The Participants

One of the unique aspects of this symposium was the diverse range of stakeholders in attendance. Attendees from in and around the assisted living industry included national leaders of the major provider organizations such as NCAL and ALFA; consumer representatives from AARP; healthcare professionals, including the American Assisted Living Nurses Association; regulators, including the California Community Care Licensing Southern Regional Manager Myron Taylor; as well as providers, related professionals, consumers, and researchers. This diversity allowed for a fantastic sharing of ideas to address the myriad medication management issues facing the industry.

The Issues

Panelists, industry experts, and symposium attendees worked together to identify the top issues in each topic area (prescribing, dispensing, and administering/documenting), and more importantly, concrete action steps to address these practical concerns.

While many concerns were discussed, one common thread throughout the day’s discussions was the issue of communication. Whether between resident and provider, provider and physician, or physician and pharmacist; the majority of participants had encountered communication problems in medication management.

Fortunately, communication is one of the more straightforward and correctable medication management issues facing the assisted living industry. Here are a few areas of communication to address in your facility policies and medication aide training:

1.     Pre-move in disclosure

As a provider you want potential residents and their family members/responsible parties to clearly understand your medication management practices and fees. Before they move-in explain to them the range of services you offer, additional fees for medication management (if any), as well as your expectations.

2.     Keep everyone on the same page

It is commonplace for assisted living residents to see multiple healthcare providers that each makes their own treatment recommendations and prescriptions. As a provider you have a responsibility to ensure that each of them is aware of the resident’s complete medication regimen. This can be as simple as sending a copy of the current medication administration record (MAR) with the resident to their doctor’s appointments.

3.     Report changes

Medication aides and other direct care staff have a unique relationship with the resident that often allows them to identify changes in condition-including potential adverse drug reactions-before the resident’s physician or family. It is critical however that assisted living staff not only recognize changes, but report them to the appropriate healthcare provider to ensure medication adjustments, if necessary, are made.

Going Forward

The findings and recommendations from the symposium extended far beyond the issue of communication. CEAL will be producing a white paper summarizing the symposium, and in my blog next week I will talk more about the concept of an individualized resident medication plan that was discussed during one of our breakout sessions.

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