Related Experiment Video
Updated: Jul 18, 2026
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Medication reconciliation: developing and implementing a program
Mandalyn Schwarz1, Rhonda Wyskiel
1Johns Hopkins Health System, Baltimore, MD, USA. mschwar2@jhmi.edu
Abstract:
During the past 5 years since the medication reconciliation process was formalized and automated, it has become an independent redundancy. The patient intervention rates are maintained at 30% to 35%, with ADE rates related to medication reconciliation at zero. The medication process takes into account the accuracy and appropriateness of restarting prehospital medications and current ICU medications. It includes the omission of important home medications along with inaccuracies of dosages and frequencies. This form assures that the patient is receiving continuity of care ad decreases complications of the patients health related to the changing of medications. Until recently this concept was disseminated by the staff without consistent administrative support. It was a process developed by nurses and perpetuated by nurses. Recently the administration has mandated that the process be implemented throughout the institution. A Hopkins health care-based collaborative is working to implement medication reconciliation hospital wide. The challenge exists in standardizing a process that is now specific to each functional unit. Multidisciplinary monthly meetings provided a forum for working through the barriers to incorporate these changes. This low-cost, high-impact safely initiative, if planned and performed strategically, can have a significant effect on patient safety.
Insights
Formalized medication reconciliation ensures patient safety with zero adverse drug events. This process maintains high patient intervention rates and continuity of care, reducing medication-related complications.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety Initiatives
- Clinical Pharmacy Practice
Background:
- Medication reconciliation formalized and automated over 5 years ago.
- Initially a nurse-driven initiative lacking consistent administrative support.
- Recent institutional mandate for hospital-wide implementation.
Purpose of the Study:
- To evaluate the impact of a formalized medication reconciliation process on patient safety.
- To assess intervention and adverse drug event (ADE) rates.
- To facilitate hospital-wide standardization and implementation.
Main Methods:
- Automated medication reconciliation process.
- Focus on accuracy of prehospital and ICU medication restarts.
- Inclusion of home medication omissions, dosage, and frequency inaccuracies.
- Multidisciplinary monthly meetings to address implementation barriers.
Main Results:
- Sustained patient intervention rates between 30% and 35%.
- Zero adverse drug events (ADEs) directly related to medication reconciliation.
- Ensured continuity of care and reduced medication-related complications.
Conclusions:
- Medication reconciliation is a low-cost, high-impact patient safety initiative.
- Strategic planning and multidisciplinary collaboration are crucial for successful hospital-wide implementation.
- Standardization across units is a key challenge requiring ongoing effort.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
01:28Dosage Regimens: Designs and Approaches
01:24Dosage Regimen: Individualization
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:30Guidelines for Nursing Documentation I
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
01:26Pharmaceutical Poisoning: Potential Scenarios