Getting into the Rhythm: Medication Reconciliation Improves the Discharge Dance

July 26, 2022


Getting into the Rhythm: Medication Reconciliation Improves the Discharge Dance

When a hospital discharges a patient to a nursing home, it sets in motion a carefully choreographed sequence of events that must be performed seamlessly to ensure the best possible outcome. One crucial component of this discharge dance is medication reconciliation, which requires the hospital’s pharmacy team to coordinate each patient’s medication list across facilities. While it sounds like that should be a straightforward exercise, that’s not typically the case because these sites often use incompatible systems and different drug formularies.

Despite everyone’s best intentions, last-minute prescribing changes, outdated medication history lists, and prescription instructions that aren’t translated cleanly into the receiving system can cause the process to fall flat. As a result, people can end up right back in the hospital shortly after discharge.

“When a patient comes to us from a nursing home, we do a lot of work in the hospital to get the patient healthy before transferring them back. Unfortunately, we see too many patients returning to the hospital or being readmitted because the nursing home didn’t receive the updated medication information they needed to continue our recommended therapies,” explains Madeline Camejo, PharmD, VP and Chief Pharmacy Officer at Baptist Health South Florida.

The importance of coordinating this information during transitions from one care setting to another is why one of The Joint Commission’s National Patient Safety Goals for 2022 focuses on having clinicians compare the medications a patient should be using (and is actually using) to the new medications that are ordered for the patient and resolving any discrepancies. In addition to the negative patient outcomes associated with omissions, duplications, and errors in medication history lists, inaccuracies also can contribute to readmissions, which cost an average of $11,000 per patient.1  

In a recent episode of Becker’s Healthcare Podcast, Dr. Camejo and Sara Panella, PharmD, BCPS, Manager of Pharmacy Ambulatory Care, Population Health, and Transitions of Care at Baptist Health, discuss their adoption of technology to gather more complete, clean medication history data.

“In the past, it was a lot of manual work, calling pharmacies, calling doctor’s offices, figuring out what medications patients were on,” says Dr. Panella. “Even though we have these great electronic health records, the list we had within our systems was stagnant. Now we have technologies that help us be dynamic in our process and remove a lot of the manual process behind obtaining the patient’s medication history list.”

Listen to the full conversation to hear how this health system’s pharmacy is working to keep patients safe.

  1. Medication Reconciliation Model ROI. Society of Hospital Medicine.

About DrFirst
author image

Since 2000, DrFirst has pioneered healthcare technology solutions and consulting services that securely connect people at touchpoints of care to improve patient outcomes.