RECONCILIATION OF MEDICATIONS ACROSS THE CONTINUUM OF CARE

Sponsored by the Nebraska Hospital Association and the University of Nebraska Medical Center

What is medication reconciliation? 
It is a process for obtaining and documenting a complete list of the patient's current medications upon the patient's admission to the organization, with the involvement of the patient. This process includes a comparison of the medications the organization provides to those on the list. A complete list of the patient's medication is communicated to the next provider of service when it refers or transfers a patient to another setting, service, practitioner, or level of care, within or outside the organization. Simple definition - all medications are appropriately and consciously continued, discontinued or modified.

This “Medication Reconciliation Toolkit” is provided by the Critical Access Hospital Network of Brown County Hospital, Ainsworth; Rock County Hospital, Bassett, Dundy County Hospital, Benkelman; Callaway District Hospital, Callaway; Tri Valley Health System, Cambridge; Cozad Community Hospital, Cozad; Franklin County Memorial Hospital, Franklin; Gothenburg Memorial Hospital, Gothenburg; Chase County Community Hospital, Imperial; Kearney County Health Services, Minden; Valley County Health System, Ord; Webster County Community Hospital, Red Cloud; and Good Samaritan Hospital, Kearney.

This Critical Access Hospital Network has generously shared their forms, procedures, a poster and power point presentation they developed to educate their communities on the importance of patients having an accurate list of medications, including over-the-counter drugs and herbal medications, which can be updated by their healthcare providers each time they seek care.

Personal Health Information Record – a card for patient’s to carry
Know Your Medications – a poster
Medication History/Discharge Order Form/Patient Instructions
Medication History/Order Form (link to landscape med reconcil form.doc)
Medication Reconciliation Worksheet 
Medication Reconciliation Monthly Audit 
Medication Reconciliation power point presentation
Medication List Verification Policy and Procedure

COPIS table
Consensus document developed by workshop attendees, which identifies the steps in the medication reconciliation process.

Form examples
Examples of forms used in the medication reconcilation process that were shared at the conference include: 

• Resource List for Medication Reconcilation Information
• University of Massachusetts Medication Reconciliation Form
• Missouri Baptist Medical Center Medication Reconciliation Form 
• Luther Hospital Medication Reconciliation Form 
• Luther Midlefort Hospital-Mayo Health System Medication Reconciliation Flow Sheet 
• BEERS Criteria
• Sample Press Release