Jeffrey Weiss, MD
Jason Adelman, MD
Patients take significantly more prescription and nonprescription medication that ever before, thereby increasing the complexity of drug interactions and potential for adverse reaction. Medication reconciliation, the process of comparing a patient´s medication orders to all of the medications he/she has been taking, can prevent medication errors such as omissions, duplications, dosing errors, or drug interactions. The potential impact of medication reconciliation is significant. The Institute of Safe Medication Practice estimates that 50% of medication errors and 20% of adverse medical events could be eliminated with proper medication reconciliation.
Medication errors can occur at any changes in setting, service, practitioner, or care level, particularly when patients are discharged from healthcare facilities. Effective medication reconciliation has been shown to improve communication during discharge, successfully reducing errors that may result in injury and even death. The Joint Commission now requires that medication reconciliation be performed at each care transition point.
As a result of a recently implemented system, upon admission to Montefiore Medical center, patients' home medication lists are often available on the RxPad module of the hospital's Clinical Information System or as an imported document from C-EMR, the ambulatory software currently rolling out across the medical center.
Upon discharge, RxPad is updated with the appropriate medication list and the system generates a patient-friendly take-home medication list. The medication list can also be generated during outpatient visits.
This system has improved the efficiency of the medication reconciliation program and the accuracy of patients' take-home medication lists. These computer-generated forms have improved the legibility of the lists.