EPITOME (Enhanced Patient Safety Intervention to Optimize Medication Education) is an evidenced-based program, modeled from the results of a medication education risk assessment conducted at the University of Pittsburgh Medical Center (UPMC). This preliminary assessment had demonstrated a significant increase in patient specific medication knowledge and a positive impact on patient medication adherence and patient satisfaction with medication use (Calabrese 2003).

EPITOME involves the entire healthcare team:

• A supportive medical staff and administrative leadership staff
• Nurses as primary teachers
• Pharmacists and respiratory therapists as supportive teachers and patient consultants.

EPITOME provides real time bedside teaching to patients about their medications. This education is spread over the entire hospital stay, rather than being compressed into the day of discharge. The patient’s educational program is tailored and modified as the medication regimen is modified.

In addition to the nursing education component patients are targeted for clinical pharmacist consultation and education if a patient is on a complex medication regimen.  This is defined as a patient scheduled to have more than five daily medication administration times, is admitted on 10 or more medications, or is started on 5 or more medications during the hospital stay destined to be continued upon discharge.  Further, nurses are free to ask for consultative and teaching help for patients they deem to be in need of the additional focus.

All patients receiving respiratory therapy medications (i.e., nebulized or inhalant therapy) receive supplemental education and training by respiratory therapy staff.

EPITOME draws on health behavior change theory and utilizes a multidisciplinary approach, including structured medication education, administrative support and staff training, established quality improvement techniques, and consistent use of adjunctive or supportive information technology and automated systems, to maximize the impact of medication education provided to patients and increase the program’s sustainability.

Patient safety outcomes of interest include polypharmacy (commonly defined as the concurrent use of four or more medications) (Rollason 2003), 30-day hospital readmission, patient satisfaction, and medication adherence behaviors.