title: Pharmacy-based medication reconciliation program utilizing pharmacists and technicians: a process improvement initiative.
abstract: BACKGROUND
  Pharmacists and pharmacy technicians have an opportunity to impact the quality of the medication histories and improve patient safety by ensuring accurate medication lists are obtained and complete reconciliation has occurred with the admission medication orders by owning the admission medication reconciliation process.
  
  
  OBJECTIVE
  To compare the quality of a pharmacy-based medication reconciliation program on admission utilizing pharmacists and technicians to the usual multidisciplinary process.
  
  
  METHODS
  This was a retrospective chart review process improvement study at a 186-bed tertiary care inpatient facility. Primary outcomes included both the accuracy of pre-admission medications listed and the reconciliation of those medications with admission inpatient orders. Technicians obtained patient medication histories. Pharmacists checked the technician-obtained medication histories and ensured reconciliation of those medications with admission orders.
  
  
  RESULTS
  Medication accuracy increased from 45.8% to 95% per patient (P < .001) and medication reconciliation increased from 44.2% to 92.8% (P < .001) and remained above benchmark.
  
  
  CONCLUSIONS
  A pharmacy-based medication reconciliation program utilizing both pharmacists and technicians significantly increased the accuracy and reconciliation of medications on admission. These gains were maintained for the duration of the 6-month period studied and beyond per continued process improvement data collection.
authors.affiliation: Pharmacy Clinical Coordinator.
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Smith
authors.affiliation: Director of Pharmacy Services, Carolinas Medical Center Mercy, Charlotte, North Carolina. Corresponding author: Michael D. Mango, PharmD, MBA, Carolinas Medical Center Mercy, 2001 Vail Avenue, Charlotte, NC 28207; phone: 704-304-5859; e-mail: Mikedmango@comporium.net.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mango
keywords: admission; medication reconciliation; process improvement