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Medication reconciliation in the hospital: what, why, where, when, who and how?
1Department of Pharmacy, University Health Network, and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario. olavo.fernandes@uhn.ca
Abstract:
Medication reconciliation arose as the solution to the well-documented patient safety problem of unintentionally introducing changes in patients' medication regimens due to incomplete or inaccurate medication information at transitions in care. Unfortunately, medication reconciliation has often been misperceived as a superficial administrative accounting task with a "pre-occupation with completing forms," resulting in the implementation of ineffective processes. In this article, the authors briefly review the evidence supporting medication reconciliation but focus more on key practical questions regarding the elements of an effective medication reconciliation process: what it should consist of, where and when it should occur, who should carry it out and how hospitals should implement it. The authors take the why of medication reconciliation to consist not just of the professional obligation to avoid causing harm, but also of a rational self-interest on the part of healthcare leaders. The authors argue that, rather than wasting time implementing a nominal reconciliation process, we should invest time and energy in a more robust and effective strategy, and they address specific practical questions that arise in such an effort.
Insights
Medication reconciliation is crucial for patient safety, preventing medication errors during care transitions. This study emphasizes effective strategies over superficial processes for better patient outcomes.
Area of Science:
- Patient Safety
- Healthcare Management
- Clinical Pharmacy
Background:
- Medication errors during care transitions are a significant patient safety concern.
- Medication reconciliation aims to prevent these errors by ensuring accurate medication information.
- Current reconciliation processes are often perceived as administrative tasks, leading to ineffectiveness.
Purpose of the Study:
- To review evidence supporting medication reconciliation.
- To address practical aspects of implementing effective medication reconciliation processes.
- To highlight the importance of robust strategies for healthcare leaders.
Main Methods:
- Literature review of evidence supporting medication reconciliation.
- Analysis of practical questions concerning effective medication reconciliation.
- Discussion of implementation strategies for healthcare organizations.
Main Results:
- Medication reconciliation is vital for patient safety.
- Ineffective, superficial reconciliation processes are common.
- Effective reconciliation requires strategic investment and focus on practical elements.
Conclusions:
- Healthcare leaders should prioritize effective medication reconciliation for patient safety and operational efficiency.
- Investing in robust reconciliation strategies is more beneficial than superficial administrative tasks.
- Addressing practical implementation questions is key to successful medication reconciliation.
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