Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management

About 400,000 patients are affected by adverse drug events (ADEs) each year at a national cost of approximately $3.5 billion. Johns Hopkins Hospital researchers, led by Linda Costa and Bob Feroli, have evaluated the effectiveness of a nurse-pharmacist clinical information coordination team in improving medication reconciliation management on admission and discharge, quantified potential harm due to reconciliation failures and determined the cost-benefit related to averted harm. Preliminary findings quantify how much each adverse drug event costs based on the literature, the cost of the nurse-pharmacist intervention and how many ADEs could be avoided with appropriate intervention. Elements of the intervention include having nurses obtain home medication lists from patients, using a set of criteria to involve the pharmacist, and accessing multiple sources including community pharmacists and primary care physicians to complete the list. Discrepancies between the admission and discharge medication orders were resolved by consultation with the hospital provider. Thus far, their work suggests that medication reconciliation at the time of admission and at discharge is important in avoiding ADEs, improving patient safety and reducing healthcare costs.

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Interprofessional collaboration (R2)
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Dr. Linda Costa
Dr. Robert Feroli