Medication Reconciliation Application Goes Live
BWH’s new medication reconciliation application, which monitors and keeps track of patients’ medications throughout their care, went live in July.
BWH is working to improve communication about medications at transition points, such as hospital admissions, transfers to other facilities and discharges. The goal of medication reconciliation is to reduce the likelihood of error by requiring clinicians to review previous medication orders alongside new orders when patients move from one setting to another, and to reconcile any differences in the medications. The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) now requires hospitals to have a medication reconciliation process in place.
Medication reconciliation is a four-step process performed each time a patient is admitted:
•Patients should keep a list of the medications they take, the doses and the reasons they take them. They should bring this list with them to every doctor’s appointment and when admitted to the hospital.
•Upon admission, clinicians must collect and document a list of all prescription and non-prescription medications, herbals and supplements taken before admission.
•Clinicians must review and verify this list with the patient and/or another caregiver.
•Clinicians must compare and reconcile the list of preadmission medications with the medications ordered for the patient’s care at the time of admission and again at discharge.
There must be communication about the ordered medications to the next health care setting the patient is going to, such as an extended care facility or agency.
To make documentation more efficient and accessible for clinicians, the electronic version of the medication list, called the Pre-Admission Medication List (PAML), is now available in BICS Computer Order Entry. The admitting clinician should complete the list of the patient’s home medications before writing admission orders. Every attempt should be made to complete the list within 24 hours of admission.
A recurring message in computer order entry will remind clinicians responsible for creating the PAML if the PAML is not started within eight hours or completed within 24 hours of admission.
For more information, contact Erin Graydon-Baker, Tejal Gandhi, MD, or Jeffrey Schnipper, MD.