What are the best practices for improving medication reconciliation accuracy in geriatric care?

1 Involve the patient and caregivers

One of the best ways to ensure accurate medication reconciliation is to involve the patient and their caregivers in the process. They are the most reliable sources of information about the patient's medication history, preferences, and adherence. You should ask them to bring all the medications they are taking, including prescription drugs, over-the-counter products, supplements, and herbal remedies, to every visit. You should also ask them about any changes, problems, or questions they have about their medications. You should use open-ended questions, active listening, and teach-back techniques to elicit and confirm their understanding.

2 Use standardized tools and protocols

Another best practice for improving medication reconciliation accuracy is to use standardized tools and protocols that guide you through the process and reduce the risk of errors. You should use a structured medication reconciliation form that captures all the relevant information, such as drug name, dose, frequency, route, indication, and start and stop dates. You should also follow a clear protocol that defines the roles and responsibilities of each team member, the timing and frequency of medication reconciliation, and the documentation and communication methods. You should also use electronic health records, clinical decision support systems, and medication reconciliation software to facilitate and automate the process.

3 Collaborate with other providers

A third best practice for improving medication reconciliation accuracy is to collaborate with other providers who are involved in the patient's care. This includes primary care physicians, specialists, pharmacists, nurses, home health aides, and social workers. You should share and update the patient's medication list with them regularly, and consult them about any discrepancies or potential issues. You should also coordinate the patient's transitions of care, such as from hospital to home or from one facility to another, and ensure that the medication reconciliation is done at each point. You should also educate and empower the patient and their caregivers to communicate with other providers about their medications.

4 Review and reconcile medications regularly

A fourth best practice for improving medication reconciliation accuracy is to review and reconcile the patient's medications regularly. You should not assume that the medication list is accurate or up-to-date, as changes may occur due to new prescriptions, discontinuations, adjustments, or self-medication. You should review and reconcile the patient's medications at every visit, and especially when there is a change in the patient's condition, treatment plan, or care setting. You should also monitor the patient's response to their medications, and check for any adverse drug events, drug interactions, or medication errors.

5 Educate and follow up with the patient and caregivers

A fifth best practice for improving medication reconciliation accuracy is to educate and follow up with the patient and their caregivers about their medications. You should provide them with clear and concise information about the purpose, benefits, risks, and instructions of each medication. You should also give them a written or electronic copy of their updated medication list, and encourage them to keep it handy and share it with other providers. You should also follow up with them after each visit or transition of care, and remind them to take their medications as prescribed, report any problems or concerns, and ask any questions they have.

6 Evaluate and improve the process

A sixth best practice for improving medication reconciliation accuracy is to evaluate and improve the process. You should measure and monitor the quality and outcomes of medication reconciliation, such as the frequency, completeness, accuracy, and timeliness of the process, and the incidence and severity of adverse drug events, hospital readmissions, and patient satisfaction. You should also identify and address any barriers, challenges, or gaps in the process, such as lack of time, resources, training, or coordination. You should also seek and implement feedback, suggestions, and best practices from the patient, their caregivers, and other providers.

7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?