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Use a 24-hour window to reconcile medications

Pharmacy Regulation Resource, March 23, 2005

Reconcile a patient's medications within 24 hours of admission. That window will buy time to obtain an accurate list of medications in difficult situations and help the hospital comply with a JCAHO National Patient Safety Goal.

Using a 24-hour window to reconcile medications helps hospital staff obtain an accurate list from patients who may arrive at the hospital in the middle of the night or who may be unconscious, says Kathleen Chahanovich, MSN, nurse manager of the medical/surgical unit at Harrington Memorial Hospital in Southbridge, MA.

Tip: See if a family member can help compile the patient's medication list. If the patient came to the hospital from a nursing home, call the facility for assistance.

Determine which staff member is best suited to reconcile medications and collect a patient's drug list, says Frank Federico, RPh, an Institute for Healthcare Improvement (IHI) director. Depending on the hospital and its resources, that could be a nurse, pharmacist, or pharmacy technician.

"This is asking people to change how they do their work," Federico says. "You can't implement a reconciliation process overnight."

IHI made medication reconciliation part of its 100,000 Lives Campaign to save that many patients by June 14, 2006.

Hospitals will need to determine how efficient their process is currently in order to find areas for improvement, Federico says, meaning organizations should collect baseline data before making any changes.

Tip: Count the number of unreconciled medications, Federico says. Compare that to the number of medications that should have been ordered to find the performance gap.

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