Implementation of medication reconciliation at admission and discharge in Ministry of Defense Health Services hospitals: a multicentre study.

There is potential for many medication errors to occur due to the complex medication use process. The medication reconciliation process can significantly lower the incidence of medication errors that may arise from an incomplete or inaccurate medication history as well as reductions in length of hospital stay, patients' readmissions and lower healthcare costs.The quality improvement collaborative project was conducted as a pilot study in two hospitals, then implemented on a broader scale in 18 hospitals in Saudi Arabia. The goal of the project was to reduce the percentage of patients with at least one outstanding unintentional discrepancy at admission by 50%, over 16-month period (July 2020-November 2021). Our interventions were based on the High 5's project medication reconciliation WHO, and Medications at Transitions and Clinical Handoffs toolkit for medication reconciliation by Agency for Healthcare Research and Quality. Improvement teams used the Institute of Healthcare Improvement's (IHI's) Model for improvement as a tool for testing and implementing changes. Collaboration and learning between hospitals were facilitated by conducting learning sessions using the IHI's Collaborative Model for Achieving Breakthrough Improvement. The improvement teams underwent three cycles.By the end of the project significant improvements were observed. The percentage of patients with at least one outstanding unintentional discrepancy at admission showed a 20% reduction (27% before, 7% after; p value <0.05) (Relative Risk (RR) 0.74) with a mean reduction in the number of discrepancies per patient by 0.74. The percentage of patients with at least one outstanding unintentional discrepancy at discharge showed 12% reduction (17% before, 5% after; p value <0.05) (RR 0.71) with a mean reduction in the number of discrepancies per patient by 0.34.Compliance to medication reconciliation documentation within 24 hours of admission and discharge showed significant improvement by an average of 17% and 24%, respectively. Additionally, the implementation of medication reconciliation had a negative correlation with the percentage of patients with at least one outstanding unintentional discrepancy at admission and discharge.

Collaborative improvement project to decrease maternal mortality rate across five hospitals in Saudi Arabia.

Maternal morbidities and mortalities remain high globally, yet are preventable events. Maternal haemorrhage is a primary cause of both maternal morbidity and mortality. In this collaborative project, multipronged evidence-based interventions, inclusive of embedded morbidity surveillance trigger tools were implemented to increase maternal morbidity reporting and improve the safety culture, while structured morbidity and mortality reviews aided in the reduction maternal mortality.

Improving hospital flow 'Ensiab Project'.

Emergency department (ED) boarding is an indicator of less efficient hospital flow and is associated with longer inpatient length of stay, higher readmission rates and increased risk of mortality and medical errors. In addition to being associated with poor patient and staff satisfaction.This article describes the efforts of six tertiary care governmental hospitals in the Kingdom of Saudi Arabia that have enrolled in a collaborative improvement project to reduce ED boarding time.The hospitals implemented a multifaceted system intervention that included forming multidisciplinary flow improvement teams, implementing the National Health Service (NHS) SAFER patient flow bundle, visual management system and multidisciplinary ED bed huddles.By the end of the project, all hospitals significantly reduced ED boarding time with a pooled mean difference of - 7.1 hours (16.6 before, 9.5 hours after, p<0.001), reaching a pooled average of 2 hours in March 2020.Furthermore, by the end of the third learning session, all hospitals were able to achieve a boarding time below 6 hours. The enrolled hospitals also experienced an improvement in hospital flow process measures without any increase in 30-day readmission rates or bed occupancy rates.Our project demonstrates that implementing multifaceted system-wide interventions improves hospital flow and ED boarding time. Additionally, our project demonstrates a significant correlation between improvements in ED boarding time, daily consultant-led rounds and early discharge from inpatient units and time till discharge.

Prevalence of obesity among military personnel in Saudi Arabia and associated risk factors.

OBJECTIVE: To measure the prevalence of obesity among military personnel in the Kingdom of Saudi Arabia (KSA), and to identify its risk factors. METHODS: This nationwide cross-sectional study covered all 5 military regions of KSA. It included a multistage stratified random sample of 10,500 active military personnel. The World Health Organization STEP wise approach to chronic disease risk factor surveillance (STEPS) was used in the design of the data collection tool. The project lasted from January 2009 to February 2011. RESULTS: The response rate was 97.4%; 40.9% of the participants were overweight, 29% obese, and 42.4% had central obesity. Multivariate analysis revealed age, education years, and family history of diabetes or hypertension as statistically significant positive predictors of body mass index, while higher military rank, smoking, eating fruits more than twice per week, and heavy physical activities were negative predictors. CONCLUSION: Obesity is a major health problem among military personnel in this survey especially among soldiers, and is associated with unhealthy dietary and physical activity habits. Prompt action must be taken by the military medical services department in terms of intervention programs primarily directed to soldiers and overweight personnel to control obesity and mitigate its consequences. Review of the anthropometric standards for recruitment, continuation, and promotion in military service is recommended.