PAML Fosters Patient Safety
To improve patient safety, BWH implemented a new computerized medication reconciliation application that monitors and tracks patients’ medications across the continuum of care.
BWH is working to improve communication about medications at transition points, such as hospital admission, transfer and discharge. The goal of medication reconciliation is for clinicians to partner with patients to reduce the likelihood of error at admission or when patients move from one setting to another. Clinicians involve patients in developing an accurate list of medications taken by the patient at home, document the preadmission home medication list in the computer and compare new orders to this list. The Joint Commission for Accreditation of Healthcare Organizations requires hospitals to have a medication reconciliation process in place.
The electronic version of the Pre-Admission Medication List—or PAML—makes the patients’ medication history more accessible to the multidisciplinary care team. The PAML is available in BICS Computer Order-Entry. The admitting clinician completes the list of the patient’s home medications before writing admission orders. Every attempt should be made to complete this list within 24 hours of admission.
Nurses then review the PAML with the patient and compare it to the medication orders written on admission, transfer or discharge. This process reduces errors and ensures there are no discrepancies in the patients’ medication orders.
A recurring message in computer order-entry reminds admitting clinicians to complete the PAML within 24 hours. The treating clinician, Nursing and Pharmacy work together to resolve any medication uncertainties.
E-mail Erin Graydon-Baker at egraydonbaker@partners.org or Ellie Bergeron, RN, at ebergeron@partners.org with questions.