Reducing medication errors and improving systems reliability using an electronic medication reconciliation system.

Area of Science:

• Health Informatics
• Patient Safety
• Clinical Pharmacy

Background:

• Medication reconciliation (MedRecon) is a Joint Commission National Patient Safety Goal since 2006.
• Limited research exists on evaluating electronic MedRecon systems for reducing medication errors and improving process reliability.

Purpose of the Study:

• To evaluate the effectiveness of an electronic MedRecon system in reducing medication errors.
• To assess the impact of computerized alerts on MedRecon process reliability and physician compliance.

Main Methods:

• An electronic MedRecon system was implemented in an acute inpatient facility.
• Two analyses were conducted: a 2-week pilot (120 events) and a 17-month evaluation (19,356 events).

Main Results:

• Unintended medication discrepancies decreased from 20% to 1.4%.
• Factors like nighttime admission and >4 home medications correlated with higher discrepancy rates.
• Computerized alerts boosted MedRecon compliance from 34% to 98%-100%.

Conclusions:

• An electronic MedRecon system, integrated into a multidisciplinary process, substantially reduces admission medication errors, enhancing patient safety.
• Interactive alerts improve system reliability by ensuring physician compliance with MedRecon procedures.
• While CPOE decision support aids error prevention, it is insufficient alone to prevent prescribing errors.