What is Medication Reconciliation?

 Medication reconciliation is the process by which a health care provider obtains a list of medications the patient is currently taking, compares (reconciles) that list to the orders of the physician, maintains and updates this list during a hospital stay, and reviews it once again to ensure that the patient has an accurate list when being discharged from the hospital.  The last step of the process is providing this list to the next provider of care.  The greatest challenge is getting the most accurate list of medications in the first place.

 Another challenge hospitals and clinics are faced with is trying to communicate changes in medications to the next provider of care.  Joint Commission of Accredited Hospitals Organization has developed a Patient Safety Goal to help direct participating hospitals and clinics.  Both Madelia Community Hospital and Madelia Clinic/ISJ Mayo Health System are accredited by Joint Commission and are working on this goal.  

 Imagine this scenario:  You have been brought to the emergency room by ambulance, short of breath and lethargic.  As the doctor examines you, the EMT provides the nurse with 4 pill bottles that were sitting on the windowsill in the kitchen.  The nurse reviews your chart from the last time you were in the hospital.  She finds that you had been discharged on 6 medications and the bottles provide only a partial match.  It’s Saturday night, the clinic is closed, and your prescriptions were filled at two different pharmacies.  The nurse asks you what medications you take, and you reply, “a small blue pill with breakfast and two big white ones at bedtime.”  You now begin to realize what a challenge medication reconciliation can be and how important it is that you always have an accurate medication list with you.

 “Our nurses and doctors told us that getting accurate medication information from the patients is the most difficult part of the whole process,” says Candace Fenske, Administrator, Madelia Community Hospital.  “We knew that in order to do our best with medication reconciliation, we needed to teach the public what we expect of them in terms of their medications.”

 Madelia Community Hospital and Madelia Clinic/ISJ Mayo Health System will launch a community education campaign this summer.  It will include articles in the local newspapers and the hospital newsletters, community forums, and eventually, patients will be able to print a blank medication form from the hospital’s website to fill in at home.  They should keep a copy in their purse or wallet and bring it with them every time they visit a doctor, dentist, eye doctor or other health care provider.  

In addition, the Madelia Community Hospital Auxiliary has invested in the File of Life.  This magnetic folder is placed on the refrigerator.  A sticker is placed in the window of the door most likely to be used by EMT’s.  They know to look for the File of Life when they see this sticker.  This provides important medical information to hospital personnel when the patient is not able to.  These files can be picked up at Madelia Community Hospital.

Watch the local newspapers for future educational opportunities to learn more about what you can do to help protect yourself.  In the meantime, follow these simple rules:

1. Keep a list of medications that you take, including non-prescription.  Be sure to include dosage and frequency, and why you take the medication.  Also include allergies to medications.

2. Tell your health care provider how you take your medication, especially if it is different than prescribed.

3. Question anything you don’t understand.  Ask for written information.

4. If you have difficulty understanding, bring a relative or friend with you.