Reality: Where We Generally Are

Vision: Where We Want to Be

Environmental Context for Medication-Use Processes

Patients experience disjointed care, with confusing/contradictory medication management.

Medication treatment management programs are supported with incremental funding.

Adoption of electronic medical records and e-prescribing continues to be slow.

Financial incentives and baseline e-prescribing standards rapidly accelerate adoption.

Commercial pharmacy quality assurance and improvement activities are voluntary and inconsistent.

Medication management/pharmacy quality assurance and quality improvement are mandatory in all settings.

Medication safety education is fragmented and inconsistently delivered to the interdisciplinary team.

Stakeholders develop and disseminate standardized interdisciplinary medication education safety programs.

Direct-to-consumer marketing can result in misleading claims about the effectiveness of medications.

Clinicians and patients have the information they need to make informed decisions about medications. Manufacturers agree to curb claims in their advertising.

Medication information resources are scattered and disjointed.

Consumer-based resource centers for medication and safety information are widely distributed.

Drug naming, labeling, and information sheet development are complex and confusing and lead to errors.

A focused research agenda is aimed at determining what strategies and tactics can improve understanding and reduce errors.

The legal environment discourages transparency, reporting, and learning, as well as appropriate responses to claims.

All components of the medication-use system, including the patient, consider the current legal and claims system fair and just.

Some adverse medication events with harm are unavoidable—“the cost of doing business.”

A concerted effort is made to reduce, minimize, or mitigate harm by reconsidering current treatment plans, dosing levels, and/ or use of adjunctive therapy.

NOTE: This table is organized around the chain of effect in improving health care quality as identified by Berwick (2002).

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