Background: Heart failure is a deadly epidemic with over 37 million people affected worldwide with a multitude of physical, psychological and financial implications on patients and the healthcare system. The progression of heart failure can be prevented by appropriate and persistent medication therapy however previous research has estimated forty to sixty percent of patients with [...]

Background: Medication errors occur frequently at transitions of care and lead to significant patient harm. Robust medication reconciliation practices can mitigate these errors, but this process is complex and time-consuming. One of the conclusions of the first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) was that pharmacist team involvement in medication reconciliation is a key [...]

Background: Electronic prescribing (eRx) at discharge enhances safety and quality of care transitions. It results in improved medication adherence and a decreased chance of readmission. Stage 3 Meaningful Use goals include discharge eRx rates of greater than 25%. As of September 2017, our large academic medical center had a year-to-date discharge eRx rate of 18.3%, [...]