MEDICATION RECONCILIATION DURING TRANSITIONS OF CARE: How to Catch Errors, Improve Patient Safety and Reduce Readmissions

Comprehensive Pharmacy Services customizes and implements hospital medication reconciliation program to drive transitions of care performance.


Patients often receive new medications or have changes made to their existing
medications at times of transitions in care—upon hospital admission, transfer from
one unit to another during hospitalization, or discharge from hospital to home or
another facility. Caregivers at these transition points may inadvertently omit needed
medications, unnecessarily duplicate existing therapies, or contain incorrect dosages.
These discrepancies place patients at risk for adverse drug events, which have been
shown to be one of the most common types of adverse events after hospital discharge
and a key driver of hospital readmissions.

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