Electronic medication reconciliation and medication errors

Abstract

Objective: To measure the impact of electronic medication reconciliation implementation on reports of admission medication reconciliation errors (MREs).

Design: Quality improvement project with time-series design.

Setting: A large, urban, tertiary care children's hospital.

Participants: All admitted patients from 2011 and 2012.

Interventions: Implementation of an electronic medication reconciliation tool for hospital admissions and regular compliance reporting to inpatient units. The tool encourages active reconciliation by displaying the pre-admission medication list and admission medication orders side-by-side.

Main outcome measure: Rate of non-intercepted admission MREs identified via a voluntary reporting system.

Results: During the study period, there were 33 070 hospital admissions. The pre-admission medication list was consistently recorded electronically throughout the study period. In the post-intervention period, the use of the electronic medication reconciliation tool increased to 84%. Reports identified 146 admission MREs during the study period, including 95 non-intercepted errors. Pre- to post-intervention, the rate of non-intercepted errors decreased by 53% (P = 0.02). Reported errors were categorized as intercepted potential adverse drug events (ADEs) (35%), non-intercepted potential ADEs (42%), minor ADEs (22%) or moderate ADEs (1%). There were no reported MREs that resulted in major or catastrophic ADEs.

Conclusions: We successfully implemented an electronic process for admission medication reconciliation, which was associated with a reduction in reports of non-intercepted admission MREs.

Keywords: medical errors; patient safety, adverse events; patient safety, quality improvement; quality management, children; setting of care; specific populations, hospital care.