Improving medication safety with accurate preadmission medication lists and postdischarge education.
In this study, preadmission medication reconciliation accuracy was dramatically improved from a baseline of 16% up to 89% by the use of pharmacy technicians in the emergency department (ED). This likely was the major contributor to the reduction of observed inpatient medication errors from 13.2% down to 1.5% postintervention. The authors also describe a separate pharmacist-driven postdischarge educational effort for complex patients. Implementation of the Safe Med program significantly decreased 30- and 60-day readmissions and ED visits. These findings contribute to prior literature that suggest pharmacist-led interventions have the most promise for improving medication reconciliation and decreasing adverse drug events (although at least one study failed to show benefit). An AHRQ WebM&M commentary discusses a case of medication error leading to a preventable readmission.