Medication Reconciliation: It's a paper process, it's an electronic process, it's the physicians responsibility, it's the nurses responsibility, it's the patients responsiblity...... yes, it is in fact all of these things. The one constant i've observed in over 100 hospitals is that there is no constant. The core prinicipals still apply

• Obtain an accurate medication history
• Communicate with the next care giver
• Reconcile at each transition point
• Discharge the patient with the correct regimen

and the core issues still abound

• What is the best way to obtain a complete history
• What is the best process for communicating to the next care giver
• Who is performing the reconciliation
• Do we have enough resources to comply
• Am I making the most informed decisions

So far, i've been privy to many processes and many success stories. I've also seen an enormous amount of frustration. For the most part, there has been a shift in focus from "having" to do medication reconciliation because Joint Commission requires it to "Wanting" to do medication reconcilation because it really makes a difference in patient safety.

more to come......