Outcomes of Medication Reconciliation at Patient Ward in a Community Hospital in the Northeast

Abstract

Objectives: To evaluate the outcomes of medication reconciliation (MR) before and after the improvement of working system in a community hospital in the Northeastern region. Methods: The researchers collected secondary data from inpatient medical records and computer databases before and after improvement of MR system for 6 months. In the period before system improvement, data were collection during April 1- September 30, 2020. The development of record form and system implementation took one month in October 2020. In the period after system improvement, data were collected during April 1- September 30, 2020. Subjects were patients with chronic diseases, aged 18 years and over, receiving at least one medication for chronic diseases and staying at least one night in the hospital. Main outcomes of the study were: 1. percentage of patients with MR within 24 hours, 2. discrepancies between medications prescribed and those currently taken by patients, and 3. rate of prescribing errors per 1,000 hospital days Results: The numbers of participants before and after system improvement were 62 and 62, respectively. When comparing pre and post improvement level, proportion of patients with MR within 24 hours increased from 93.55% to 98.38%. Discrepancies between medications prescribed and those currently taken by patients at the admission declined from 21.29% to 12.50 % of the items of medication. However, those at the discharge slightly increased from 12.42% to 13.07 %. Medication errors during admission decreased from 125 per 1,000-hospital day to 12.34 per 1,000 hospital day. The severity of medication errors reduced from level C and D to level C. Medication errors during the discharge were found only in the pre-system improvement period at 5.21 per 1,000 hospital day with severity at the C level. The most common types of errors were commission and omission. Conclusion: The MR process implemented at the hospital was able to reduce medication errors and the severity of incidences. The MR process is an important process that helps patients receive correct and appropriate medication.