Improving Medication Reconciliation

The Problem
Medication reconciliation—comparing a patient's medication orders to all medications the patient has been taking—helps to avoid medication errors such as omissions, duplications, dosing errors and drug interactions. The Institute for Safe Medication Practice estimates that 50 percent of medication errors and 20 percent of adverse medical events could be eliminated with proper medication reconciliation.
For CCRMC, CEO Jeff Smith, MD, recognized in late 2004 that the hospital's current quality improvement methodologies from the 80s and 90s were insufficient to achieve higher levels of improvement. With this level of executive sponsorship, Steven Tremain, MD, chief medical officer, was asked to develop a team to help redesign clinical processes. A top priority of redesign was meeting the requirements for medication reconciliation. Director of ancillary services Stephanie Bailey was asked to lead a team in the rapid development of a medical reconciliation process that would quickly be adopted by physicians and nurses and establish a standard for ongoing process improvements.
The Solution
CCRMC set out to establish a reliable process for medication reconciliation at all points of hospital-based care. At the same time, CCRMC sought to develop a repeatable process and an organizational mindset for continually developing and improving clinical activities and systems—quickly and effectively.

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