Northwestern Memorial Hospital Logo

• About Us
• MATCH Initiative
• Our Team


• MATCH Toolkit
• Making the Case
• Defining the Problem
• Assembling a Team
• Designing the Process
• Implementation
• Education and Training
• Assessment


• For Patients
  
• Trusted Resources


• Disclaimer

Home

Making the Case for Medication Reconciliation

Commitment to the process of medication reconciliation at all levels of an organization is essential to success. The tools on this page are intended to assist you in your effort to educate leadership and healthcare providers on the importance of medication reconciliation and the potential impact on patient safety. With many organizational initiatives currently being implemented, senior leadership will be able to help prioritize medication reconciliation among all the other initiatives. To do this, you will need to educate them on the importance of medication reconciliation from a patient safety and regulatory point of view so they understand why it should be a priority.

A. Presenting and Communicating Medication Reconciliation

To help prepare your organization for implementing medication reconciliation, it is a good idea to support your process with external and internal data that show the importance and need for medication reconciliation. Below is a link to some "talking points" that may be useful in crafting presentations or communications with leadership, management or frontline staff. This is by no means a comprehensive review of the literature on medication reconciliation but it does highlight data published to support the process of medication reconciliation and the effects on patient safety.

Medication Reconciliation Talking Points (PDF format)

When preparing communications, documents, or presentations, it is important to know your audience. The presentation you give to your board members or CEO will be different than the presentation you give at a staff meeting of frontline caregivers. The same is true if you are presenting to different disciplines (i.e., physicians, nurses, pharmacists). Support your presentation with data, whether it is external data from the literature or your own internal data. Senior leadership will be interested learning how medication reconciliation can improve patient safety and how this process will help to achieve compliance with accreditation if required. Other audiences such as managers will be interested to hear how they can motivate their staff to participate in medication reconciliation.

Below are two example presentations that could be used when presenting on medication reconciliation to different audiences. These presentations are intended to get the conversation going about the importance of medication reconciliation. These presentations are not intended to go into the details of how the organization is going to accomplish this National Patient Safety Goal. It is important to start with the "why" and then move into "how" when everyone agrees to the importance of this process from senior leadership to frontline staff.

Making the Case for Leadership (PPT format)
Making the Case for Staff (PPT format)

B. Business Case for Medication Reconciliation

By creating a business case for medication reconciliation, you will be prepared to bring data to senior leadership to make a case for additional resources needed to perform medication reconciliation on every patient. Additionally, the sample business cases below provide a graphic reminder to organizational leaders that providing safe and quality care always makes good business sense in the end.

Business case (PDF format)

C. Case Studies

Examples of medication discrepancies leading to errors in your facility and/or sample case studies make the problem real for your audience. The following sample case studies are intended to provide your audience the opportunity to visualize how clinical processes could fail and lead to patient harm. Additional examples can be found at the Agency for Healthcare Research and Quality (AHRQ) WebM&M is an online version of morbidity and mortality rounds. A recent case and commentary published highlights medication reconciliation. This case is titled Reconciling Doses, with commentary by Frank Federico, RPh, Director of the Institute for Healthcare Improvement.

The three case studies below will be helpful in "making the case" for medication reconciliation. Many healthcare providers may be resistant to medication reconciliation not because they don't want to follow the rules but because they have not been educated on why medication reconciliation is so important. The case studies below are real situations that have been "close calls" or tragic events related to medication reconciliation. These examples can be used for morbidity and mortality rounds, online tutorials, presentations etc. Use the examples below or use them as a guide of how to present case studies of adverse events that were attributed to a lack of medication reconciliation at your organization.

After completing these case studies, one will be able to describe the roles of each caregiver in the medication reconciliation process, identify when medication reconciliation must be done during a patient's hospital course, and describe how the completion of medication reconciliation for every patient will decrease medication errors and harm.

Case study 1: Medication Reconciliation on Admission (PDF format)
Case study 2: Medication Reconciliation on Discharge (PDF format)
Case study 3: Medication Reconciliation, External Transfer (PDF format)

Conclusions from Case Study Examples:

• Medication Reconciliation is an effective process to reduce medication errors and patient harm associated with those errors.
• All caregivers must be involved in medication reconciliation in order for it to be an effective process to reduce medication errors and patient harm.
• On admission, it is imperative to collect the most accurate and complete medication history possible as well as reconcile the home medication list to the inpatient orders.
• Patient's medication lists and prescription bottles are a great start to a medication history but it doesn't replace communicating with the patient and/or patient's family to get the most accurate and up to date medication list.
• Medication reconciliation should not occur only at admission; transfer and discharge are crucial steps in medication reconciliation to ensure medication errors do not occur.