Patient Safety at Transitions of Care: Use of a Compulsory Electronic Reconciliation Tool in an Academic Hospital

Medication errors are responsible for most inpatient adverse events. Medication reconciliation emerged as an effective strategy to decrease these problems, enhancing patient safety. Electronic health records with reconciliation tools could improve the process, but many aspects should be considered in order to reach expected outcomes. In this paper we analyzed how a compulsory, electronic reconciliation application was used at Hospital Italiano in Buenos Aires, through admission and discharge processes. We evaluated all medications that were reconciled during patient admission and discharge since its implementation, from February to November 2014. During that period, there were 78,714 reconciled medications regarding 37,741 admissions (2.08 reconciled medications per hospitalization), of 27,375 patients (2.88 medications per patient). At admission, 63% of medications were confirmed and the remaining were paused or deleted. At discharge, 41% of all medications were reconfirmed. In the creation of the best possible medication history, the use of an electronic reconciliation tool would clean overloaded lists, but at the same time medications could be erroneously deleted.