Managing the medication reconciliation process. Developing a robust reconciliation process for an institution using mixed electronic/paper medical records.

One of the most difficult National Patient Safety Goals to master is to accurately and completely reconcile medications across the continuum of care. All healthcare providers can agree that reconciliation is valuable, but developing a process that will ensure this is being done at admission, transfer and discharge is difficult. Is there a provider role that should logically take ownership of this process? How can this be seamlessly incorporated into current workflow? As institutions are transitioning to electronic medical records, in a mixed electronic and paper environment, what tools need to be developed to assure that the process is followed consistently? This article will review the process used by a multidisciplinary group to develop a robust medication reconciliation process in an institution which uses a mixed electronic/paper medical record and provides both ambulatory and inpatient care.