Medication reconciliation
Ensuring accurate medicine matching at transitions of care
Communication problems between settings of care or between health professionals are a frequent cause of medication errors and adverse drug events. Unintentional changes to patients' medicine regimens often happen during hospital admissions. These unintended changes can cause serious problems during a hospital stay or when patients are discharged.
The process of medication reconciliation has been shown to reduce errors and adverse events associated with poor quality information at transfer of care and inaccurate documentation of medication histories on patient admission to hospital.
Medication reconciliation is the formal process of obtaining and verifying a complete and accurate list of each patient's current medicines, matching the medicines the patient should be prescribed to those they are actually prescribed. Any discrepancies are discussed with the prescriber and reasons for changes to therapy then documented.
When care is transferred (e.g. between wards, hospitals or home), a current and accurate list of medicines, including reasons for change, is provided to the person taking over the patient's care. Points of transition that require special attention are:
- Admission to hospital
- Transfer from the Emergency Department to other care areas (wards, Intensive Care, or home)
- Transfer from the Intensive Care Unit to the ward
- From the hospital to home, residential aged care facilities or to another hospital.
Assuring medication accuracy at transitions of care through the process of medication reconciliation is one of five patient safety priorities nominated by the World Health Alliance on Patient Safety (external site).
Medication reconciliation is also one of the eight Clinical Practice Improvement (CPI) areas of the Safety and Quality Investment for Reform (SQuIRe) Program, and one of the five standards of the WA Process of Pharmaceutical Review policy. For further information please see:
http://www.safetyandquality.health.wa.gov.au/squire/guidebooks.cfm
http://www.safetyandquality.health.wa.gov.au/medication/pharmaceutical_review.cfm
WA Medication Reconciliation Audit Tools
- Medication Reconciliation Audit Tool for Single Patient Use Version 1
- Medication Reconciliation Audit Tool for Single Patient Use Version 2
- Medication Reconciliation Audit Tool for Multiple Patient Use
WA Guidelines for Use of the Medication Reconciliation Audit Tools
National Medication Management Plan
The national Medication Management Plan (MMP) is an initiative of the Australian Commission on Safety and Quality in Health Care (the Commission).
The MMP is a standardised form to record the patient’s medicines; taken prior to presentation to hospital to reconcile the patients' medicines on admission, on intra-hospital transfer and at discharge, is considered essential for the medication reconciliation process. The MMP provides Australian hospitals with a suitable form that can be used by nursing, medical, pharmacy and allied health staff for this purpose.
Together with the National Inpatient Medication Chart (NIMC), the MMP is the accurate repository for pharmaceutical information in the medical record to enabling therapeutic decision making.
The MMP was developed in consultation with all States and Territories. It aligns with the Australian Pharmaceutical Advisory Council's Guiding principles to achieve continuity in medication management. It also incorporates the minimum data set for a medication history outlined in guiding principle 4 - Accurate medication history.
The MMP is designed for use in adult and paediatric patients.
The MMP is not mandatory. However, health services are strongly encouraged to implement it as a tool to enhance medication reconciliation and medication safety. Emphasis on inter-professional use of the MMP is strongly encouraged.
National Medication Management Plan PDF Version (external site)
Guide on how to complete the MMP (external site)
National Medication Management Plan design files can be supplied by the Commission on request. Please call (02) 9126 3600 or email mail@safetyandquality.gov.au
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