The Importance of a Sound Clinical Reconciliation Process

Within the healthcare industry, it’s difficult to overstate the importance of carefully cultivating and maintaining a sound clinical reconciliation process.

For example, picture this scenario:

An emergency department (ED) nurse enters to help an elderly patient who has just arrived via ambulance. The nurse reviews the patient’s chart from a recent hospitalization for heart failure, noticing the patient was discharged with five prescriptions that were filled at two different pharmacies. The ED nurse asks the patient what medications he is currently taking, and he says “three pills total, the white ones at bedtime and the blue at breakfast.”

Understanding and accurately documenting the patient’s medical history, allergies, and medications into an emergency department information system could prove critical in how well the ED can treat this patient. It’s also likely that this patient could end up in another hospital department and that the medication information entered at the time of his arrival—whether accurate or not—will follow this man throughout his hospital stay.

A complete and accurate knowledge and record of a patient’s problem, along with any current allergies, and medications is essential,” says Chris Bloodworth, MEDHOST Director of Clinical Product Strategy. “All of these pieces of patient information are critical for appropriately planning for the patient’s care.

Inconsistencies in knowledge and record keeping could threaten this patient’s safety and prolong his hospital stay as a result. Clinical reconciliation, which includes medication reconciliation, refers to the process of avoiding such inadvertent inconsistencies across transitions in care by reviewing the patient's complete medication regimen at the time of admission, transfer, and discharge and comparing it with the regimen being considered for the new setting of care.

Clinical reconciliation is designed to avoid the most common medical errors like duplicating medication orders, inadvertently eliminating a medication or prescribing incorrect dosages.

Though it may sound relatively simple, this back-and-forth process of comparing and reconciling new and old medications can be error-prone and sometimes laden with inconsistencies that could prove to be potentially dangerous.

In fact, adverse drug events (ADEs), or an injury resulting from medical intervention related to a drug, can occur and range from allergic reactions and medication errors to overdoses or adverse drug reactions. ADEs account for an estimated 1 in 3 of all hospital adverse events, according to the Department of Health and Human Services. These ADEs affect about two million hospital stays each year, prolonging patient stays by one to four days.

It Takes Two

A sophisticated clinical reconciliation process not only affects patient safety and their continuity of care, but also the workflow of physicians and healthcare providers. Utilizing tools within a state-of-the-art EHR management system, providers can receive prompts to inquire about changes in medication with patients and record that information at each point in a patient’s transition of care.

Though the onus is on providers to record accurate and complete patient data, it’s also important that providers communicate with patients about keeping an updated medication list handy in case of an emergency. As patients become increasingly more involved in their healthcare amid the transition to a value-based care model, medication reconciliation offers an excellent example of how patients and providers must work together to ensure that quality care is received and delivered.

MEDHOST is committed to helping hospitals and healthcare providers overcome clinical reconciliation challenges and provide clinicians with the insights they need to deliver the most-timely, relevant patient care possible. Email us at inquiries@medhost.com or call 1.800.383.6278 to learn more.

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