SHM Converge Scientific Abstract ePoster Gallery-Standardizing Medication Reconciliation: An Rx to Fix the Wreck

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This project addressed poor medication reconciliation (MR) completion among Internal Medicine residents at an academic inner-city hospital. MR is the process of verifying a patient’s medication list on hospital admission, and only 9.1% of residents were performing it in 2019. The team aimed to identify barriers to completing MR and create a standardized method for residents to use.<br /><br />A survey found that fewer than one-fourth of residents completed MR at admission. Common barriers included lack of time, difficulty navigating the electronic medical record (EMR), and patient-related factors. To improve performance, the authors implemented a resident-led educational intervention using multiple teaching formats: lectures, an instructional video, and handouts.<br /><br />After the intervention, residents reported improved confidence and frequency of MR completion. Fifty percent said they completed MR within 48 hours of admission 100% of the time, compared with 19% before the intervention. Fifty percent also reported completing MR prior to discharge, up from 38% before. However, chart review showed limited real-world improvement: only 2 of 25 patient charts (8%) had adequate MR completed before discharge, and none were completed within 48 hours of admission.<br /><br />Overall, the project showed that education alone was not enough to reliably improve MR completion. The authors concluded that future efforts should better integrate EMR support, encourage role modeling by senior residents, and build resident accountability into the workflow. They emphasized that strong medication reconciliation skills are essential for safe, patient-centered care.

Asset Subtitle

Giuliana G. Berardi

Meta Tag

Author List Dharmini Shah Pandya, Giuliana G. Berardi, Ziyodakhon Abdujabborova

Category Innovations

Concept Medication Reconciliation

Concept Educational Intervention

Concept Internal Medicine Resident

Concept Barrier

Concept Training Modality

Distinguished Non-Finalist

Presenter Organization Temple University Hospital

Presenting Author Giuliana G. Berardi

Track Quality Improvement

Keywords

medication reconciliation

Internal Medicine residents

resident education

electronic medical record

hospital admission

patient safety

workflow improvement

academic hospital

barriers to completion

quality improvement

Medication Reconciliation

Educational Intervention

Internal Medicine Resident

Barrier

Training Modality