IPRO Authors Analyze Medication Reconciliation

A systems-based approach to medication reconciliation can support substantial reductions in hospital readmission rates, a reduced risk of adverse drug events and more costeffective service delivery, according to a new journal article by authors at IPRO’s Albany NY office, and at Seton Home Health Care and Seton Health/St. Mary’s Hospital in Troy NY. Scheduled for publication in the November/Decemberissue of Home Healthcare Nurse, the article describes collaboration among patients/families, admitting nurses and hospital pharmacists to compile an accurate list of medications patients were taking at home prior to hospital admission. These lists are reconciled with any findings available from the Regional Health Information Organization (RHIO) database, so that physicians writing hospital admitting orders have all relevant information available to them. At discharge, physicians compare lists of previously identified home medications to lists of medications administered during hospitalization. As an additional precaution, pharmacists review the same previously identified in-home medication lists against lists of inhospital prescriptions. Pharmacists also provide in-person drug counseling to patients when required. In the outpatient setting, home care nurses making initial postdischarge home visits have access to hospital pharmacists, should they have questions or concerns about medications or medication interactions. Over the course of the project, medication discrepancies fell from 81% during a six month period at the beginning of the project, to 65% for a six month period toward the end of the project. And while findings don’t demonstrate a direct correlation between interventions and readmissions, Seton Home Health Care has seen its acute care hospitalization rate drop from a recent 34% to 28% for the 10-month period ending in 2010. Findings are part of a three-year special Care Transitions project undertaken by IPRO and thirteen other QIOs that concluded last July. For electronic access to the full text of “A System-Based Medication Reconciliation Process” due in print format later this fall, visit www.homehealthcarenurseonline.com.