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Federal government websites often end in. The site is secure. Preview improvements coming to the PMC website in October Learn More or Try it out now. The protocol, statistical code, and de-identified and anonymized dataset are available from Dr. Schnipper with a reasonable written request. The first Multi-center Medication Reconciliation Quality Improvement Study MARQUIS1 demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals.
Eight hospitalists mentored the sites via one site visit and monthly phone calls over the month intervention period. Outcomes to be assessed will include unintentional medication discrepancies per patient. A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record EHR platform.
We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation. Medication errors are a major patient safety concern during transitions in care and occur across all healthcare settings. Errors arise from medication discrepancies, defined as unexplained differences among documented regimens across different sites of care [ 1 ].
In prior work, we demonstrated that general medical inpatients experienced on average at least one discrepancy with potential for patient harm in either their admission or discharge medication orders [ 2 ]. When discrepancies are unintentional and unresolved, they can cause harmful adverse drug events ADEs and substantially increase health care costs [ 3 , 4 ]. At many hospitals, the quality of medication reconciliation remains poor, and evidence-based practice is lacking [ 8 ].
