Background: Accurate medication reconciliation during transitions of care can decrease medication related adverse drug events. The Joint Commission has prioritized medication reconciliation as one of the national patient safety goals. Effective pharmacist-physician-patient collaboration can improve the medication reconciliation process and thus medication safety for hospitalized patients Purpose: 1. Develop a standardized provider-pharmacist discharge medication reconciliation [...]

Background: The first Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased unintentional medication discrepancies with potential for harm in five hospitals. Purpose: For MARQUIS2 we utilized lessons learned from MARQUIS1 to implement the toolkit across 18 diverse medical centers. Description: MARQUIS2 is a real-world, mentored [...]

Background: The Joint Commission (TJC) included medication reconciliation (MedRec) as a 2005 National Patient Safety Goal to reduce errors related to medication omissions, duplications and interactions. Medication errors and harms continue to be one of the most widely reported healthcare problems. TJC’s sentinel event database includes > 350 medication errors resulting in death or major [...]