The indicators have been designed as tools to evaluate processes involved in identification of medication-related harm in older hospitalised patients and the management of inappropriate polypharmacy. They will inform quality improvement initiatives targeting common areas of medication-related harm, such as inappropriate polypharmacy, falls, and impairment of cognitive and physical function, at the unit, department or facility level.
A number of features accompany the Polypharmacy QUM Indicators to facilitate their uptake and use. A standardised data collection tool accompanies each indicator as well as newly developed risk assessment tools to stratify older patients at risk of medication-related harm. In addition, posters to prompt clinicians to consider medication related harm have been developed. The PREMs evaluate patients’ experiences in the decision-making process for deprescribing in hospital.
The Polypharmacy QUM Indicators and their accompanying data collection tools are listed below. We strongly recommend downloading the following documents to guide use of the indicators:
- Full Resource Kit for Measuring Strategies to Reduce Harm from Polypharmacy in Australian Hospitals: QUM Indicators, PREMs and Risk Stratification Tools [PDF]
- Polypharmacy QUM Indicator and PREMs Summary List [PDF]
- Data collection tool user guide [PDF]
- Using the National Quality Use of Medicines Indicators for Australian Hospitals [PDF]
Individual Polypharmacy QUM Indicators & Resources
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Identification of older patients at high risk of medication-related harm
Polypharmacy QUM Indicator 8.1: Percentage of older patients that are appropriately assessed for risk of harm from inappropriate polypharmacy
- Indicator 8.1 Specifications [PDF] | Accompanying Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
- Inappropriate Polypharmacy Risk Assessment Tool (IPRAT) [PDF]
- Targeting Inappropriate Polypharmacy Poster [PDF]
Polypharmacy QUM Indicator 8.2: Percentage of older patients that are appropriately assessed for risk of medication-related falls
- Indicator 8.2 Specifications [PDF] | Accompanying Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
- Medication-related Falls Risk Assessment Tool (MFRAT) [PDF]
- Targeting Falls Poster [PDF]
Polypharmacy QUM Indicator 8.3 Percentage of older patients that are appropriately assessed for risk of medication-related impairment of cognitive and/or physical function
- Indicator 8.3 Specifications [PDF] | Accompanying Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
- Medication-related Impairment of Cognitive and/or Physical Function Risk Assessment Tool (FUN-RAT) [PDF]
- Targeting Cognitive & Physical Functioning Poster [PDF]
Polypharmacy QUM Indicator 8.1, 8.2 and 8.3
- Combined Indicator 8.1/8.2/8.3 Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
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Intervention: a hospital-based medication review (HBMR)
Summary Tool
- Criteria to Identify Patients at High Risk of Medication-Related Harm [PDF]
- This tool provides criteria to identify patients at high risk of medication-related harm. These patients should receive a
hospital-based medication review (HBMR), however in the event that a HBMR cannot be undertaken, a post-discharge medication review recommendation or referral should occur.
- This tool provides criteria to identify patients at high risk of medication-related harm. These patients should receive a
Polypharmacy QUM Indicator 8.4: Percentage of older patients at high risk of medication-related harms that receive a hospital-based medication review and, if applicable, a deprescribing plan
- Criteria to Identify Patients at High Risk of Medication-Related Harm [PDF]
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Optimising discharge communications and continuation of medication care at transitions of care
Polypharmacy QUM Indicator 8.5: Percentage of older patients at high risk of medication-related harms with a recommendation for a post-discharge medication review, when hospital-based medication review is not performed
- Indicator 8.5 Specifications [PDF] | Accompanying Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
Polypharmacy QUM Indicator 8.6: Percentage of older patients whose discharge summaries contain a current, accurate and comprehensive list of medicines, including explanations for any medication therapy changes and, if applicable, details of a deprescribing plan
- Indicator 8.6 Specifications [PDF] | Accompanying Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
Polypharmacy QUM Indicator 8.7: Percentage of older patients who receive a current, accurate and comprehensive medication list, including explanations for any medication changes and, if applicable, details of a deprescribing plan, at the time of hospital discharge
- Indicator 8.7 Specifications [PDF] | Accompanying Data Collection Tool [Excel] (Enable Excel workbook macros before use for full functionality)
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Polypharmacy Patient Reported Experience Measures (PREMS)
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See also other relevant resources
- Deprescribing tools webpage
- A HETI module about ‘Polypharmacy In Older Inpatients’ is currently available to NSW Health employees – Course Code: 183595643
- Report: Promoting Strategies to Reduce Harm from Polypharmacy in Australian Hospitals: Use of Quality Use of Medicine Indicators and Tools – here
Copyright
This work is copyright. It may be reproduced in whole or in part for Australian quality improvement, study or training purposes subject to the inclusion of an acknowledgement of the source and indicators being reproduced without variation from the original.
Requests and inquiries concerning reproduction and rights for purposes other than those indicated above requires the written permission of NSW Therapeutic Advisory Group Inc.:
NSW Therapeutic Advisory Group Inc. 26 Leichhardt Street, Darlinghurst NSW 2010 or nswtag@stvincents.com.au
Suggested citation
NSW Therapeutic Advisory Group. Resource Kit for Measuring Strategies to Reduce Harm from Polypharmacy in Australian Hospitals: QUM Indicators, Patient Reported Experience Measures and Risk Stratification Tools. NSW TAG 2020.
This document, with associated support materials, is available on the NSW Therapeutic Advisory Group website at www.nswtag.org.au
Page last updated: 7 March 2022
