title: Medical reconciliation in patients discharged from the emergency department.
abstract: BACKGROUND
  Medication errors are considered to be a significant cause of morbidity and mortality. For each patient, emergency departments (EDs) are expected to compile a list of medications, reconcile them, and pass them along to the next provider. The electronic medical record provides a method to automatically capture and propagate what may be incorrect information.
  
  
  OBJECTIVE
  The aim of this study was to compare the medication information that patients ultimately discharged from the ED provide to the ED staff vs. the medication information the patients provide at follow-up, and to classify and quantify the types of discrepancies between the two.
  
  
  METHODS
  We conducted a retrospective descriptive study of a convenience sample of 36 patients who were discharged from the ED and who reported taking five or more medications. Discrepancies were identified by comparing information collected at the time of the index ED visit with that gleaned from follow-up contact within 7 days of discharge.
  
  
  RESULTS
  Of the 36 charts analyzed, 286 medications were provided by patients at the time of their ED visit. Subsequent determination of actual medication use on follow-up found 120 discrepancies, for a discrepancy rate of 42.0% (95% confidence interval [CI] 36.4-47.8%). One or more discrepancies were found on 86.1% of charts (95% CI 74.8-97.4%).
  
  
  CONCLUSIONS
  Frequent discrepancies are found in the medication information that patients provide in the ED. Requiring the ED to reconcile medication information and to pass it on to the next provider can be a source of treatment errors in the outpatient setting.
authors.affiliation: Department of Emergency Medicine, Good Samaritan Hospital Medical Center, West Islip, New York 11795, USA.
authors.forename: Adhi N
authors.initials: AN
authors.lastname: Sharma
authors.forename: Ronald
authors.initials: R
authors.lastname: Dvorkin
authors.forename: Veronica
authors.initials: V
authors.lastname: Tucker
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Margulies
authors.forename: David
authors.initials: D
authors.lastname: Yens
authors.forename: Anthony
authors.initials: A
authors.lastname: Rosalia
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003625:Data Collection / Q000592:standards; D057286:Electronic Health Records / Q000592:standards*; D004636:Emergency Service, Hospital; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D059065:Medication Reconciliation / Q000145:classification* / Q000592:standards* / Q000706:statistics & numerical data; D010343:Patient Admission; D010351:Patient Discharge; D062209:Patient Handoff; D012189:Retrospective Studies; D055815:Young Adult