Summary
Hennepin County Medical Center implemented a multidisciplinary medication reconciliation process for patients discharged to skilled nursing facilities, with the goal of ensuring that multiple reviews occur in a timely manner. As part of each discharge order, the physician writes medication orders and performs the initial medication reconciliation within 4 hours of a nursing home bed becoming available. A clinical coordinator and pharmacist then review the order, with the pharmacist meeting with the physician if needed to resolve discrepancies. As a final check, the bedside nurse reviews the orders and communicates pertinent information to the nursing home. The program virtually eliminated medication errors and reduced readmissions by nearly half, leading to significant cost savings.
Evidence Rating
Moderate: The evidence consists of an 11-month study of patients discharged to nursing homes that compared medication errors and readmissions within 30 days in those receiving the revised reconciliation process with a group of similar patients receiving traditional reconciliation, along with estimates of the cost savings generated from reductions in readmissions.
Developing Organizations
Hennepin County Medical Center
Date First Implemented
2009
Patient Population
Age > Aged adult (80 + years); Vulnerable Populations > Frail elderly; Age > Senior adult (65-79 years)
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