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Illinois system's reconciliation efforts a success

Pharmacy Regulation Resource, October 12, 2005

Improving how hospitals report a patient's medication requirements across departments and units greatly decreases incidents of adverse drug events. Reconciliation is a key component to the Institute for Healthcare Improvement's "100,000 Lives" campaign.

In Illinois, an entire alliance of hospitals made medication reconciliation a top priority. Starting with pilot programs in one hospital, the healthcare group now employs innovative methods to keep accurate medical records for patients and has reduced its incidents of adverse drug events from 3.84 per 1,000 patients to 1.39 per 1,000 in only five years. Their efforts have been so successful, the Illinois Hospital System this year started the program in 26 hospitals across the state.

The hospital's efforts to reduce medication errors was part of its implementation of manufacturing efficiency standards, according to OSF Saint Francis Director of Patient Safety <b>Cassy Horack, RN, BSN.</b>

The first step was to define medication reconciliation. Horack says the hospital decided the process had three distinctive steps:

• the collection of a complete medication list for the patient
• the treating physician consciously decides what medications to order for the patient
• the pharmacy is involved to fill the order and update the patients' medication list

"Medications for us include over-the-counter and herbal or alternative therapies," says Horack. "Once we defined all of these things, we decided who would do what in the process."

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