Medication reconciliation is a common strategy to improve patient safety. However, previous research has documented implementation challenges and the potential for patient harm due to process failures.

This article describes the experiences of three academic medical centers which implemented risk scoring systems to identify patients with the highest likelihood of medication reconciliation-related errors. Two of the academic medical centers (AMC 1, AMC 2) implemented risk stratification scoring tools developed as part of the MARQUIS2 study, while the third developed an electronic health records (EHR) risk calculator based on risk factors associated with medication reconciliation based on a literature review (AMC 3). In addition to implementation of the risk stratification tools, each of the medical centers introduced changes to existing workflows and clinical responsibilities regarding collection of best possible medication history for high-risk and non-high-risk patients.

The researchers found that AMC 1 showed the strongest impact on medication reconciliation errors. Although AMC 2 used the same risk stratification tool, they used a different implementation plan and did not show improvements in high-risk patients. AMC 3 also showed favorable results, although the findings were not as robust as AMC 1.