PMID- 19241731
OWN - NLM
STAT- MEDLINE
DCOM- 20090421
LR  - 20220408
IS  - 1553-7250 (Print)
IS  - 1553-7250 (Linking)
VI  - 35
IP  - 2
DP  - 2009 Feb
TI  - Reducing medication errors and improving systems reliability using an electronic 
      medication reconciliation system.
PG  - 106-14
AB  - BACKGROUND: Medication reconciliation (MedRecon) has been a Joint Commission 
      National Patient Safety Goal since 2006. However, there is scant literature on 
      the evaluation of electronic MedRecon systems in reducing medication errors and 
      on improving reliability of the MedRecon process. METHODS: An electronic MedRecon 
      system was designed and implemented in an acute inpatient care facility. Two 
      analyses were performed: (1) one based on a 2-week pilot evaluation of the system 
      based on 120 MedRecon events, and (2) a more comprehensive 17-month evaluation of 
      the system, based on 19,356 MedRecon events. RESULTS: The unintended discrepancy 
      rate between a patient's home medications and admission medication orders was 
      reduced from 20% during the pilot phase to 1.4%. The omission of a home 
      medication was the most common type of discrepancy. Nighttime admission (8 P.M.-8 
      A.M.), total home medications > four, patient age > 65 years, and resident 
      physician performing the medication reconciliation were found to have a 
      significant positive correlation (p < .05) with the discrepancy rate. Using 
      computerized alerts improved compliance with the MedRecon process from 34% to 
      98%-100%. DISCUSSION: Using a multidisciplinary process based on an electronic 
      system substantially reduced medication errors on admission, suggesting that an 
      electronic MedRecon system can be an important tool in improving patient safety. 
      The use of an interactive reminder alert in the MedRecon system improved systems 
      reliability by ensuring physician compliance with MedRecon performance. Although 
      computerized physician order entry (CPOE) decision support tools are an important 
      component of medication error prevention strategies, they alone are not 
      sufficient to prevent errors of prescribing.
FAU - Agrawal, Abha
AU  - Agrawal A
AD  - Central Brooklyn Family Health Network, New York, USA. agrawal.abha@gmail.com
FAU - Wu, Winfred Y
AU  - Wu WY
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Jt Comm J Qual Patient Saf
JT  - Joint Commission journal on quality and patient safety
JID - 101238023
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical History Taking/methods
MH  - Medical Order Entry Systems/organization & administration/*standards
MH  - Medical Record Linkage/methods/*standards
MH  - Medication Errors/*prevention & control
MH  - Middle Aged
MH  - Patient Admission
MH  - Pharmacy Service, Hospital/methods/organization & administration/*standards
MH  - Pilot Projects
MH  - Quality Assurance, Health Care/methods
EDAT- 2009/02/27 09:00
MHDA- 2009/04/22 09:00
CRDT- 2009/02/27 09:00
PHST- 2009/02/27 09:00 [entrez]
PHST- 2009/02/27 09:00 [pubmed]
PHST- 2009/04/22 09:00 [medline]
AID - S1553-7250(09)35014-X [pii]
AID - 10.1016/s1553-7250(09)35014-x [doi]
PST - ppublish
SO  - Jt Comm J Qual Patient Saf. 2009 Feb;35(2):106-14. doi: 
      10.1016/s1553-7250(09)35014-x.