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Reality: Where We Generally Are
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Vision: Where We Want to Be
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Environmental Context for Medication-Use Processes
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Patients experience disjointed care, with confusing/contradictory medication management.
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Medication treatment management programs are supported with incremental funding.
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Adoption of electronic medical records and e-prescribing continues to be slow.
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Financial incentives and baseline e-prescribing standards rapidly accelerate adoption.
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Commercial pharmacy quality assurance and improvement activities are voluntary and inconsistent.
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Medication management/pharmacy quality assurance and quality improvement are mandatory in all settings.
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Medication safety education is fragmented and inconsistently delivered to the interdisciplinary team.
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Stakeholders develop and disseminate standardized interdisciplinary medication education safety programs.
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Direct-to-consumer marketing can result in misleading claims about the effectiveness of medications.
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Clinicians and patients have the information they need to make informed decisions about medications. Manufacturers agree to curb claims in their advertising.
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Medication information resources are scattered and disjointed.
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Consumer-based resource centers for medication and safety information are widely distributed.
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Drug naming, labeling, and information sheet development are complex and confusing and lead to errors.
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A focused research agenda is aimed at determining what strategies and tactics can improve understanding and reduce errors.
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The legal environment discourages transparency, reporting, and learning, as well as appropriate responses to claims.
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All components of the medication-use system, including the patient, consider the current legal and claims system fair and just.
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Some adverse medication events with harm are unavoidable—“the cost of doing business.”
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A concerted effort is made to reduce, minimize, or mitigate harm by reconsidering current treatment plans, dosing levels, and/ or use of adjunctive therapy.
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NOTE: This table is organized around the chain of effect in improving health care quality as identified by Berwick (2002).
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