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Table 3 Suggestions for strategies based on barriers and drivers found

From: Medication reconciliation at hospital admission and discharge: insufficient knowledge, unclear task reallocation and lack of collaboration as major barriers to medication safety

Barriers and drivers Implementation strategy
A lack of awareness of benefits of bundle Process mapping of the medication reconciliation process to get insight into inefficiencies
The bundle does not meet the wishes or needs of professionals Tailoring bundle to local barriers and needs of professionals
Compatibility Use uniform and electronic forms between departments and between inpatient and outpatient setting
Insufficient knowledge of professionals Inform, thoroughly, professionals about the medication reconciliation process
  Use a training and implementation toolbox, including tools for transferring knowledge and forms for generating feedback
  Generate feedback about professionals’ performance with quality indicators
Feedback Use a central database for medication errors occurring in inpatient and outpatient settings to generate feedback
Collaboration between hospital and community caregivers Adopt a multidisciplinary team approach including hospital and community caregivers generating a common purpose
Limited knowledge of patient Encourage patient empowerment through medication education
Competitive spirit Facilitate competition by publishing and comparing the performance of departments
Extra resources to measure indicators Integrate the measurement of indicators with existing ICT tools
Unavailable information from community pharmacies Adopt a regional or national electronic medication patient file
during out of office hours  
Task reallocation Reallocate tasks to those professionals who are best educated to perform medication reconciliation
  Incorporate community pharmacists into the medication reconciliation process, due to their knowledge of comorbidities and medication history
Multiple interventions at once Synthesise the implementation of different interventions when possible