Electronic Tool Improves Medication Reconciliation

An electronic tool that encouraged active medication reconciliation upon admission to the hospital reduced the rate of medication reconciliation errors by 58%, according to the results of a study.

An electronic medication reconciliation tool could reduce the number of medication errors when patients are admitted to the hospital, the results of a recent study suggest.

The study, presented on May 5, 2014, at the 2014 Pediatric Academic Societies Annual Meeting in Vancouver, Canada, analyzed the impact of an electronic tool for medication reconciliation during admission at Boston Children’s Hospital. The tool was introduced into the electronic health record from November 2011 through June 2012 and encouraged active reconciliation. The electronic tool displayed pre-admission medications on one side of a split screen, and allowed users to modify the list of post-admission medication orders on the other side. A pre-existing safety event reporting system identified medication safety events and identified whether they were related to medication reconciliation or not. The researchers compared error rates before and after the electronic tool was introduced.

A total of 33,070 admissions were recorded during the study period, and the medication reconciliation tool was used for 75% of admissions in the post-intervention period. Medication history was documented for 89% of admissions before the introduction of the tool, and 93% of admissions after the tool had been used. The results also indicated that the number of medication reconciliation errors decreased significantly after the tool was introduced, from 5.9 errors per 1000 admissions before the intervention to 2.5 errors per 1000 admissions after the intervention, for a 58% reduction. Throughout the study period, a total of 146 admission medication reconciliation errors were identified. These errors were classified as near miss (35%), reached the patient but resulted in no harm (42%), resulted in minor transient change in condition (22%), or resulted in a transient change in condition that required monitoring or additional intervention (1%). No error resulted in patient resuscitation, transfer to the intensive care unit, or permanent harm.

“These findings support ongoing national efforts related to medication reconciliation to improve patient safety and the role of the tools used,” the study authors conclude.