Medical Reconciliation as a Patient Safety Strategy

Kuriakose S

doi:10.34297/ajbsr.2021.14.001993

Abstract

Patient Safety has increasingly been receiving attention over the last couple of decades due to a combination of legal suits against hospitals due to negligent care, which could have been avoided, and an increased awareness in the medical community that steps can be taken to mitigate issues which could compromise a patient’s health. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an accrediting non-governmental body that accredits the vast majority of hospitals and other medical facilities in the United States on the quality of the medical standards, has listed comprehensive medication reconciliation as one of its 2015 National Patient Safety Goals [2]. JCAHO further states, “There is evidence that medication discrepancies can affect patient outcomes.”

Highlights

Medication reconciliation is intended to identify and resolve discrepancies it is a process of comparing the medications a patient is taking with newly ordered medications
Organizations should identify the information that needs to be collected to reconcile current and newly ordered medications and to safely prescribe medications in the future.” [2]. The article this author chose was published in 2013 in the Annals of Internal Medicine, Janice Kwan and his colleagues estimated that 67% of patients admitted to hospitals have unintended discrepancies in the medications started in the inpatient units [3]
The recommendation, which Kwan described as being the most successful in reducing the percentage of unintended medical errors, was called best possible medication history (BPMH). This process involved a clinician conducting a structured interview with a competent patient and eliciting their medication used while confirming this information from a reliable source such as a pharmacy and/or the patient’s outpatient primary care physician [3]. The completion of this process involved a second phase which was called the best possible medication discharge plan (BPMDP); a process involving a clinician examining the medicines given to the patient in the hospital and transferring these medications to the patient’s pharmacy and relaying this information to the patient’s outpatient primary provider while sitting with the patient and going over all these medications to ensure that the patient understood them [3]

Summary

Introduction

Medication reconciliation is intended to identify and resolve discrepancies it is a process of comparing the medications a patient is taking (and should be taking) with newly ordered medications. Organizations should identify the information that needs to be collected to reconcile current and newly ordered medications and to safely prescribe medications in the future.” [2] The article this author chose was published in 2013 in the Annals of Internal Medicine, Janice Kwan and his colleagues estimated that 67% of patients admitted to hospitals have unintended discrepancies in the medications started in the inpatient units [3]. These patients often were on a different medication regimen before their hospital admission and notwithstanding the medications started for specific hospitalized indications; these patients were discharged on the wrong medication protocol

Findings

Discussion

Conclusion and Recommendations