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MEDICATION RECONCILIATION

With every transition of care, comes an opportunity to deliver better outcomes – by implementing a system that helps you check patient medications against their orders.

We start with a review of the hospital-provided patient medication list. We then compare that to the patient’s medication history, interviewing family if necessary. We will also contact the drug supplier and the patient’s primary care physician. We then address any discrepancies, and our pharmacists communicate those to the hospital staff. Our pharmacists can perform a second review after validation of the home medication list and after admission orders are submitted. This thorough process applies to discharge medication reconciliation as well.

More than half of patients have one or more unintended medication discrepancies at hospital admission. We can help you lower those odds.

More than half of the patients have a ≥ 1 unintended medication discrepancy at hospital admission


Source: Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005;165:424-429.

CPS Advantages:

  • Pharmacist driven process, not RN or MD
  • An external retail database is used to validate home medication lists and assess patient compliance
  • Ability to make changes directly within hospital EMR
  • Ability to utilize trusted resources when site is closed or staff is unavailable
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