Medication safety needs rounds: reducing medication-induced harm in aged care homes

Residents of aged care homes are often exposed to high-risk medications. Medication management problems are the most frequent reason for residential care complaints to the Aged Care Quality and Safety Commission. From July 2024, pharmacists can work onsite in aged care homes providing clinical, governance, and education services. Australia is one of the first countries to implement onsite pharmacists and there is a need to provide them with new tools and structures to proactively address medication safety issues. Our multisite implementation project draws on the evidence-based principles of nurse-led ‘palliative care needs rounds.’ Needs rounds typically involve a monthly cycle of identifying residents with the most pressing care needs, conducting a triage meeting to discuss needs and develop action plans, which triggers clinical work with residents, staff education, or multidisciplinary meetings. We will adapt this robust approach to provide a new pharmacist-led model targeting medication safety needs in aged care homes. This feasibility study will incorporate a mixed methods approach to work collaboratively with health professionals, aged care staff, residents and families to adapt the existing palliative care need rounds model, and codesign implementation processes and resources to inform the delivery of medication safety needs rounds. We will implement and evaluate the processes and outcomes of medication safety needs rounds in 6 Australian aged care homes and conduct an intervention scalability assessment to inform future testing or scale up. This project is led by a diverse team with expertise in pharmacy, medicine, nursing, aged care, codesign, consumer engagement, health economics and implementation of palliative care needs rounds. It leverages a critical window of opportunity to equip onsite pharmacists and aged care teams with an evidence-based process to intervene to reduce medication-induced harm in aged care homes and improve resident health and wellbeing.