Improving patients’ health is impossible without promoting better cooperation between hospitals and patients. Reconciling medication is an important step toward better quality of care, and is one of the major goals set by the Joint Commission. Goal 8 set by the Joint Commission states that hospitals are obliged to “accurately and completely reconcile patient medications across the continuum of care” (The Joint Commission, 2008).
In this context, reconciling medication is not a matter of choice, and patients’ health and safety totally depends on whether medical professionals are able to obtain, assess, and use information about patients with the aim to reduce the risk of transition-related adverse drug events (The Joint Commission, 2008). According to Young (2008), 1. 5 million of preventable ADEs occur in the United States annually, which means that at least one medication error impacts one patient per day.
To minimize the incidence of medication-related injuries, medical facilities should realize that medical reconciliation involves the three different stages: (1) verification by gathering accurate medical information; (2) clarification by checking appropriateness of medications prescribed; and (3) reconciling and documenting every change (Young, 2008). Objectively, reconciling medications is not a difficult process, but given the barriers which medical professionals face on their way to better quality of care, reconciliation may turn into an unachievable goal.
Here, we should bear in mind that there is no universal system of reconciliation. Moreover, reconciliation requires high level of collaboration and cooperation across the care continuum. In any situation, patients and family members remain the primary sources of medical information, and medical professionals should be particularly cautious regarding polypharmacy in older patients (Young, 2008). It should be noted though, that patient literacy is one of the most significant issues that impede the progress of professional initiatives in terms of reconciling medications.
In their study, Persell et al (2007) suggest that patients themselves frequently fail to name their medications, and thus may not be able to provide medical professionals with the information they need to reconcile several different types of drugs. That is why trying to improve the quality of medical care, special emphasis needs to be placed on improving the efficacy of communication between various departments; and it is very probable that the success of Joint Commission’s initiatives will depend on our ability to link separate medical units into one cohesive system of medical communication.
References Persell, S. D. , Osborn, C. , Richard, R. , Skripkauskas, S. & Wolf, M. S. (2007). Limited health literacy is a barrier to medication reconciliation to ambulatory care. Journal of General Internal Medicine, 22 (11): 1523-1526. The Joint Commission. (2008). Disease-specific care certification. National patient safety goals. The Joint Commission. Retrieved March 9, 2009 from http://www. jointcommission. org/NR/rdonlyres/74937937-7B39-447A-AA6F-AFD8BAEE1410/0/DSC_NPSG. pdf Young, B. (2008). Medication reconciliation matters. MEDSURG Nursing