Abstract
Purpose
To assess the quality of the performance of the medication reconciliation process during hospital admission.
Methods
Subjects were randomized by facility over a 30-day period. Standardized questionnaires were utilized to obtain demographic information, drug allergies, and medication histories. This information was compared with medication reconciliation forms completed upon hospital admission. The primary outcome was the percent of accurate forms completed by the admitting clinician. Secondary outcomes were the accuracy of individual components of the medication order and the time required to accurately reconcile medications.
Results
One hundred fourteen medication reconciliation forms were audited; over half the subjects were white males with a mean age of 51 years and a median of 7 home medications. Accurate medication reconciliation was documented on 13% of forms. Allergies were consistent among providers in 59% of patients. Of 742 medication orders, the number of inaccuracies was as follows: wrong dose (108, 14.6%), wrong frequency (108, 14.6%), wrong route (54, 7.3%), and wrong medication (25, 3.4%). Omissions (204) and commissions (98) occurred at a rate of 1.79 and 0.86, respectively (114 forms evaluated). The majority of patient/caregiver, outpatient provider, and retail pharmacy interviews required 15 minutes or less to complete.
Conclusions
Though a national benchmark does not exist for the quality of medication reconciliation performed on hospital admission, there are opportunities to increase the accuracy of medication information obtained during hospital admission.
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