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A Review of Medication Reconciliation Issues and Experiences with Clinical Staff and Information Systems

Journal:Applied Clinical Informatics
ISSN:1869-0327
DOI:http://dx.doi.org/10.4338/ACI-2010-02-R-0010
Issue:Vol. 1: Issue 4 2010
Pages:442-461

A Review of Medication Reconciliation Issues and Experiences with Clinical Staff and Information Systems

Review

P. J. Porcelli (1), L. R. Waitman (2), S. H. Brown (3)

(1) Department of Pediatrics, Wake Forest University, Winston-Salem; (2) Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS; (3) Department of Veterans Affairs, Department of Biomedical Informatics, Vanderbilt University, Nashville, TN

Summary

Medication reconciliation was developed to reduce medical mistakes and injuries through a process of creating and comparing a current medication list from independent patient information sources, and resolving discrepancies. The structure and clinician assignments of medication reconciliation varies between institutions, but usually includes physicians, nurses and pharmacists. The Joint Commission has recognized the value of medication reconciliation and mandated implementation in 2006; however, a variety of issues have prevented simple, easy, and universal implementation. This review references issues related to the development and the implementation of medication reconciliation including: – the need of a system or standard for accurate drug identification to create a definitive ‘gold standard’ patient medication list, – identifying stakeholders of medication reconciliation within the institution and contrasting staff interest and participation with institutional resources, – observations and opportunities of integrating medication reconciliation with the electronic patient health record, and – summarizing a series of institutions experiences developing and implementing medication reconciliation. Last, as medication reconciliation becomes a regular process within medical centers, key concepts for effective implementation are discussed.

Keywords

Medical Informatics, Patient safety, medical errors, Medication reconciliation, drug errors, pharmaceuticals

DOI

http://dx.doi.org/10.4338/ACI-2010-02-R-0010

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