Polypharmacy is common among veterans. This articles describes the Veteran Health Administration’s implementation of an electronic, portable medication management tool to reduce polypharmacy by using the principles of high reliability organizations and combining best practice evidence, interprofessional teams, patient engagement, and integration of existing medical records systems. After three-years of implementation, an average of 2.15 medications were deprescribed per patient, with the most common being antihypertensives, over-the-counter medicines and antidiabetic medications.
Boggan JC, Shoup JP, Whited JD, et al. J Gen Intern Med. 2020;35:2136-2145.
Remote triage, which can be delivered via telephone, email or video conference, has been linked to potential adverse events. This systematic review evaluated the effects of remote triage systems on healthcare utilization and patient safety outcomes. Of the eight studies identified, three cluster RCTs found high rates of call resolution in local, practice-based triage services compared with regional or national services. Two cluster trials examined the effects of remote triage on mortality, hospitalizations and ED visits; neither reported statistically significant differences indicating increased risk for these patient safety outcomes.
Washington, DC: Department of Veterans Affairs, Office of Inspector General. January 7, 2020. Report No. 19-00468-67.
Systemic weaknesses challenge safe care in Veterans Affairs health systems facilities. This report analyzed a patient suicide at one medical center and determined contributors to the failure. This report shares recommendations to address deficiencies including improved communication across the care continuum and reliably acting on root cause analysis results.
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