SHM Converge Scientific Abstract ePoster Gallery-A Hospitalist Led Initiative to Improve Medication Reconciliation on Admission

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A hospitalist-led quality improvement initiative was launched to improve admission medication reconciliation (AdmMedRec) on inpatient rehabilitation units at a large academic medical center after safety reports identified missed doses of critical medications. Review of existing workflow showed inconsistent and incorrect use of the EHR AdmMedRec function, a common problem in hospitals where physicians may not perceive its value. Rather than using disruptive hard stops or interruptive alerts, the team focused on three areas: knowledge, process, and culture.<br /><br />The intervention was led by a hospitalist-clinical informaticist working with a provider champion. It included: defining core competencies for AdmMedRec, delivering an in-person interactive case-based training session, creating a clear step-by-step workflow, incorporating underused EHR tools into daily practice, building a real-time dashboard to show completion status, and setting performance targets while engaging leadership and provider champions.<br /><br />AdmMedRec completion rates were compared for four months before and after the intervention on the rehabilitation units, with the rest of the hospital serving as control. Completion improved from 13% at baseline to 87% post-intervention on the intervention units, while control units did not change meaningfully. A gradual increase occurred in the three months after the process review, and the unit with an embedded provider champion showed more sustained improvement than the unit without one.<br /><br />The project demonstrated that medication reconciliation can be significantly improved without adding pharmacists or using EHR-based interruptive alerts. The authors believe success depended on combining competency-based training, workflow redesign, real-time visibility, and a strong culture of medication safety. Future work will examine whether gains are sustained, whether medication errors decrease, and whether the approach can be replicated elsewhere.

Asset Subtitle

Kai Xu

Meta Tag

Author List Kai Xu

Category Research

Concept Medication Reconciliation

Concept Patient Safety

Concept Medication Error

Concept Process Redesign

Concept Medication Safety Culture

Distinguished Non-Finalist

Presenter Organization University of Pennsylvania

Presenting Author Kai Xu

Track Quality Improvement

Keywords

medication reconciliation

admission medication reconciliation

hospitalist-led quality improvement

inpatient rehabilitation

electronic health record

workflow redesign

provider champion

patient safety

clinical informatics

quality improvement initiative

Medication Reconciliation

Patient Safety

Medication Error

Process Redesign

Medication Safety Culture