Developing a programme for medication reconciliation at the time of admission into hospital
- 724 Downloads
The aim of this article is to describe the methods used to develop the medication reconciliation programme implemented in a tertiary care hospital, and to discuss the main problems encountered and lessons learned during the process. A quasi-experimental study was carried out, analysing discrepancies between routine medication and drugs prescribed in the hospital, before and after an electronic reconciliation tool was introduced at admission. This tool was integrated into the computerized provider order entry system. The implementation of the electronic reconciliation tool has shown a reduction of the rate of discrepancies, decreasing from 7.24% (CI 95% 6.0–8.5) before the intervention to 4.18% (CI 95% 3.2–5.1) afterwards. Projects like this are costly, but this study has made it possible to detect numerous areas where interventions could be useful and proved the importance of a medication reconciliation programme.
KeywordsAdverse drug events Computerised reconciliation tool Discrepancies Medication error Medication reconciliation Risk management
We are very grateful for the cooperation and interest of the whole team (Preventive Medicine, General Surgery, Internal Medicine and Pharmacy staff) who took part in the study and development of the programme. It would not have been possible without their help.
The project was funded through a collaborative agreement between the Spanish Ministry of Health and Social Policy and the authorities of the Autonomous Region of Madrid.
Conflicts of interest
- 2.Institute for Healthcare Improvement (IHI). Getting started kit: prevention of adverse drug events. Medication reconciliation. How to guide [document on the internet]. IHI; 2007 (cited 20 March 2011). Available from: http://www.ihi.org.
- 4.Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Medication reconciliation national patient safety goal to be reviewed (document on the internet). JCAHO; 2010 (cited 30 Aug 2010). Available from: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/npsg8_review.htm.
- 5.World Health Organization (WHO). Collaborating Centre for Patient Safety Solutions. Assuring medication accuracy at transitions in care. Patient safety solutions (document on the internet). WHO; 2007 (cited 30 Aug 2010). Available from: http://www.who.int/patientsafety/solutions/patientsafety/PS-Solution6.pdf.
- 6.National Institute for Health and Clinical Excellence (NICE) and the National Patient Safety Agency (NSPA). Technical patient safety solutions for medicines reconciliation on admission of adults to hospital (document on the internet). NICE & NSPA; 2007 (cited 30 Nov 2010). Available from: http://guidance.nice.org.uk/index.jsp?action=download&o=38560.
- 11.Anderson HJ. Medication reconciliation: What role will I.T. play? Health Data Manag. 2007;15(7):44, 46, 48.Google Scholar
- 15.Roure Nuez C, compiler. Documento de consenso en terminología y clasificación de los programas de conciliación de la medicación. 1st ed. Barcelona: Ediciones Mayo; 2009.Google Scholar
- 16.The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). NCC MERP index for categorizing medication errors (document on internet). NCC MERP; 2001 (cited 30 Aug 2010). Available from: http://www.nccmerp.org/pdf/indexColor2001-06-12.pdf.