Medication Reconciliation

​Medication safety is particularly vulnerable during care transitions—at admission, during level-of-care cha​nges within the institution, and at discharge. Among the medication errors that can occur are omissions from the patient​'s home medication list, medication dosing mistakes, duplication of therapies, and failure to restart at discharge any medications that were discontinued during the patient's hospitalization.

The process of medication reconciliation is intended to prevent medication errors by systematically evaluating the medications a patient is taking to ensure that any medications that are added, changed, or discontinued are carefully reviewe​​d, with the goal of maintaining an accurate list of the patient's medications. The process should be undertaken with every change in a patient's level of care along the continuum of care, such...