YNHHS standardizes admission medication reconciliation process

In April, all Yale New Haven Health System (YNHHS) emergency departments began using a standardized process for obtaining the prior-to-admission medication list and documenting in Epic.

"Medication reconciliation is a crucial part of the admission process, allowing the admitting provider to order the appropriate medications on admission," said Olukemi Akande, MD, project lead, YNHHS medication reconciliation improvement project. "When our workgroup first looked at the situation, we saw that obtaining and documenting the prior-to-admission medication list in Epic was disorganized and confusing, resulting in medication errors. A current medication history enables us to make informed decisions as to how medications will factor in inpatient care."

With representatives from Bridgeport, Greenwich and Yale New Haven hospitals, Northeast Medical Group, the Health Services Corp. and Epic, the medication reconciliation workgroup was able to improve the process by creating new workflows, designating responsible staff and adding enhancements to Epic.

The workgroup determined that to prevent medication errors during admissions, transfers and discharges, admitting providers needed to:

• Clearly update the STATUS of the Home Meds List using Epic's new drop-down menu in the Review Home Medications section of the admission medication reconciliation navigator.
• Complete the Admission Med/Order Reconciliation to account for medication history while placing inpatient admission orders.

Dr. Akande said that each emergency department educated its nurses before the new process was implemented and will continue to monitor adoption.