Implementing an electronic tool for medical reconciliation at hospital admission reduced the error rate from 5.9 errors per 1,000 admissions to 2.5 errors per 1,000 admissions, a decrease of 58 percent, according to an abstract of a study presented at the 2014 Pediatric Academic Societies Annual Meeting.
Researchers at Boston Children's Hospital introduced the tool into the electronic health record from November 2011 to June 2012. The tool presents a split-screen display, with pre-admission medications appearing on the left side of the screen and a modifiable list of post-admission medication orders on the right side of the screen.
Documentation of medication history among the 33,070 patients involved in the study improved from 89 percent to 93 percent from pre-intervention to post-intervention.
Additionally, 146 medication reconciliation errors were detected during the study period. These errors were categorized as a "near miss" (35 percent), reached the patient but resulted in no harm (42 percent), resulted in minor transient change in condition (22 percent) or resulted in transient change in condition requiring monitoring or additional intervention (1 percent). No error resulted in patient resuscitation, transfer to the intensive care unit or permanent harm.
Researchers concluded an electronic tool for medication reconciliation was linked to a decrease in reported admission medication reconciliation errors in a pediatric population, and these findings support continuing efforts to improve patient safety and the role of tools in medication reconciliation.
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