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Optimisation of medication reconciliation using queueing theory: a computer experiment

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Abstract

Background

Medication reconciliation (MedRec) in hospitals is an important tool to enhance the continuity of care, but completing MedRec is challenging.

Aim

The aim of this study was to investigate whether queueing theory could be used to compare various interventions to optimise the MedRec process to ultimately reduce the number of patients discharged prior to MedRec being completed. Queueing theory, the mathematical study of waiting lines or queues, has not been previously applied in hospital pharmacies but enables comparisons without interfering with the baseline workflow.

Method

Possible interventions to enhance the MedRec process (replacing in-person conversations with telephone conversations, reallocating pharmacy technicians (PTs) or adjusting their working schedule) were compared in a computer experiment. The primary outcome was the percentage of patients with an incomplete discharge MedRec. Due to the COVID-19 pandemic, it was possible to add a real-life post hoc intervention (PTs starting their shift later) to the theoretical interventions. Descriptive analysis was performed.

Results

The queueing model showed that the number of patients with an incomplete discharge MedRec decreased from 37.2% in the original scenario to approximately 16% when the PTs started their shift 2 h earlier and 1 PT was reassigned to prepare the discharge MedRec. The number increased with the real-life post hoc intervention (PTs starting later), which matches a decrease in the computer experiment when started earlier.

Conclusion

Using queueing theory in a computer experiment could identify the most promising theoretical intervention to decrease the percentage of patients discharged prior to MedRec being completed.

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Acknowledgements

The authors would like to thank the application managers of Hospital Group Twente for providing data of the MedRec process.

Funding

No specific funding was received.

Author information

Author notes

  1. W. J. Kruik-Kollöffel and G. A. W. Moltman have contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical Pharmacy, Ziekenhuisgroep Twente (Hospital Group Twente), Postbus 7600, Almelo and Hengelo, 7600 SZ, The Netherlands

    W. J. Kruik-Kollöffel & M. D. Wu

  2. Center for Healthcare Operations Improvement and Research (CHOIR), University of Twente, Enschede, The Netherlands

    G. A. W. Moltman, A. Braaksma & R. J. Boucherie

  3. Department of Clinical Pharmacy, Isala Hospital, Zwolle, The Netherlands

    M. D. Wu

  4. Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, The Netherlands

    F. Karapinar

  5. CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, The Netherlands

    F. Karapinar

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  1. W. J. Kruik-Kollöffel
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  2. G. A. W. Moltman
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Correspondence to W. J. Kruik-Kollöffel.

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Kruik-Kollöffel, W.J., Moltman, G.A.W., Wu, M.D. et al. Optimisation of medication reconciliation using queueing theory: a computer experiment. Int J Clin Pharm (2024). https://doi.org/10.1007/s11096-024-01722-0

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