Decreasing Medication Reconciliation Challenges One Admission Nurse at a Time

The hospital implemented a new admissions nurse position in March 2014 to address the quality and availability of medication reconciliation at the time of admission. The hospital's goals were to: (1) Increase the accuracy of the information documented in the EHR; and (2) Provide the medication information to the admitting physicians in a timely manner. Prior to this implementation, the floor nurse was responsible for acquiring the medication and patient history once the patient arrived at the inpatient unit, delaying the physician in entering CPOE and performing the medication reconciliation process electronically. The admission nurse has become responsible for performing the first part of the admission which includes the medication history on any patient that is going to be admitted. This process takes place in the emergency department as soon as the patient is determined to be admitted. This process has shown significant improvements in the accuracy of the medication reconciliation process, improved physician and patient satisfaction and saved floor nursing time to care for the current patients.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)