Medical reconciliation programs: Rewriting history?

A new study at Northwestern Memorial Hospital indicates that when seeking to reduce medical errors, hospital administrators should put at the forefront the goals of obtaining accurate, complete medical histories from all patients, and instituting a medical reconciliation program. Researchers found that when hospital pharmacists took specific steps to ensure that patients received the right medication at the right dosage, the rate of medication errors dropped, as did patient injury potential. With the Joint Commission on Accreditation of Healthcare Organizations' announcement that the 2005 National Patient Safety Goals will include medication reconciliation for all hospital patients, the study's relevance increases.

Fast stats

According to the study:

[white diamond suit]Without pharmacist intervention, 22% of medication discrepancies may have caused patient harm during hospitalization and 60% may have caused harm if continued after discharge.

[white diamond suit]Complete omission of a medication the patient reported taking before hospitalization was the most common discrepancy.

[white diamond suit]Also frequent was a different route, dose, or frequency of medication ordered when compared to what the patient was taking prehospitalization.

[white diamond suit]The authors believe discrepancies take place predominantly during patient discharges, intrahospital transfers, or transfers to a different hospital or nursing home.

Source: Gleason, K., et al.: "Reconciliation of Discrepancies in Medication Histories and Admission Orders of Newly Hospitalized Patients," American Journal of Health-System Pharmacy. 61:(16)1689-1695, 2004.