Medication reconciliation is “A formal process in which healthcare providers work together with patients to ensure accurate and comprehensive medication information is communicated consistently across transitions of care” and is known to decrease medication errors and reduce adverse medication events. Ensuring the information is as correct as possible at the time of documentation reduces confusion and ensures that the patient receives the intended medication therapy. Incomplete documentation of medications at transition points may actually promote incorrect medication use and sub-optimal care. There is a recognized quality scale for evaluating a best possible medication history (BPMH). Gathering data from these audits will enable managers and clinicians to improve medication reconciliation processes in their specific clinical environments. 

Expected Outcomes & Deliverables:

The ISMP-Canada Medication Reconciliation Quality Audit tool will be adapted, validated and communicated to end users and management teams. https://www.ismp-canada.org/download/MedRec/faq-purpose-medrec-quality-audit.pdf

A defined, consistent and reproduceable process for completing the audits will be developed. Information gathered from the audits will be standardized so results may be compared across clinical areas.

Student Involvement:

Working with front-line nursing, clinical educators, pharmacy professionals and management, the student will create an audit tool and reporting framework. Reports will be developed that allow managers and clinical educators to compare quality results across clinical areas and target improvement initiatives.

Resources Required:

Computer workstation, electronic health record access

Support Offered to Students (i.e. weekly meetings, mentorship, etc.):

Meetings with pharmacy team and leadership as required. Access to members of the Medication Quality & Safety Council (mentorship, meeting participation)