The Joint Commission Sentinel Event Alert, Issue 35, 2006, pertains to the use of medication reconciliation in the prevention of medication errors. This paper summarizes the content of the sentinel alert and its relation to the actual practical experience in the care of patients. Included in this paper are my observations of these issues and the practices put in place at Yale New Haven Hospital.
From the perspective of the Joint Commission (JTC) patient involvement is essential in the medication reconciliation process. It is quite possible that the state of the patient is such that active and full participation by the patient in this process is not possible. In such cases the patient may seek assistance from another individual, like a family member or surrogate decision maker, in the medical reconciliation process. In any case an essential ingredient of the medical reconciliation process is that it should be a part of every interface of care provided, from the time the patient is admitted to the time the patient is discharged from care (2006).
The JTC defines medication reconciliation process as “the process of comparing a patient’s medication orders to all of the medications that the patient has been taking.” It is mandatory at every point of transition of care, as there is the likelihood of fresh medication orders. The process consists of five steps, which are compilation of the current list of medications; creation of a list of medications that could be prescribed; making a comparison of the two lists created; taking of clinical decisions on the basis of the results of the comparison; and disseminating the information of the new list of medications to the patient and the care givers of the patient (2006).
An accurate and full medical reconciliation process can prevent the occurrence of medication prescribing and administration errors. In the opinion of ...
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