Respond substantively. Comment on the strategies identified by your peers. If you can offer help or provide insight into additional tracer methods, use this opportunity to do so.
To approach the issue of medication reconciliation for safely transitioning patients between inpatient and outpatient areas of care, it would seem to fall upon the inpatient side to take the lead a bit in the quality improvement process. As suggested by the Agency for Healthcare Research and Quality (AHRQ), employing the tracer method to investigate the prevalence of the inpatient hospital interfaces with primary care facilities should be performed on a microsystem level, taking into account the contributions of the full care team, from admission to discharge, to discover areas for quality improvement (2020). By examining the communication roles and experiences of emergency department (or direct admission) intake staff, nurses, social workers, case managers, unit secretaries, and the attending clinicians in the process of guiding patients through their stay, administrators can employ a systems approach to quality improvement rather than attributing errors to any one individual person or role (Hendrick, Montanya, & Griffith, 2007). Openly engaging with staff in regard to the purpose of the process tracer, with a specific eye toward examining communications with primary care clinicians to ensure accurate transmission of medical data, can engender empowerment and focus on the goal of improving communication and data sharing accuracy (AHRQ, 2020).
Tracer methodology can be employed for an existing process or approach to care, as suggested here, or during the course of a process implementation. However, tracing a system as it currently exists in a frozen state, can be an important function of the initial step of Plan, Do, Study, Act in much the same way that tracing is employed by Joint Commission to identify vulnerabilities in hospital or area-specific system processes (Siewert, 2018).
