title: Electronic medication reconciliation and medication errors.
abstract: OBJECTIVE
  To measure the impact of electronic medication reconciliation implementation on reports of admission medication reconciliation errors (MREs).
  
  
  METHODS
  Quality improvement project with time-series design.
  
  
  METHODS
  A large, urban, tertiary care children's hospital.
  
  
  METHODS
  All admitted patients from 2011 and 2012.
  
  
  METHODS
  Implementation of an electronic medication reconciliation tool for hospital admissions and regular compliance reporting to inpatient units. The tool encourages active reconciliation by displaying the pre-admission medication list and admission medication orders side-by-side.
  
  
  METHODS
  Rate of non-intercepted admission MREs identified via a voluntary reporting system.
  
  
  RESULTS
  During the study period, there were 33 070 hospital admissions. The pre-admission medication list was consistently recorded electronically throughout the study period. In the post-intervention period, the use of the electronic medication reconciliation tool increased to 84%. Reports identified 146 admission MREs during the study period, including 95 non-intercepted errors. Pre- to post-intervention, the rate of non-intercepted errors decreased by 53% (P = 0.02). Reported errors were categorized as intercepted potential adverse drug events (ADEs) (35%), non-intercepted potential ADEs (42%), minor ADEs (22%) or moderate ADEs (1%). There were no reported MREs that resulted in major or catastrophic ADEs.
  
  
  CONCLUSIONS
  We successfully implemented an electronic process for admission medication reconciliation, which was associated with a reduction in reports of non-intercepted admission MREs.
authors.affiliation: Department of Medicine, Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Hron
authors.affiliation: Department of Pharmacy, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Manzi
authors.affiliation: Department of Pharmacy, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Dionne
authors.affiliation: Department of Medicine, Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Chiang
authors.affiliation: Clinical Education and Informatics, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Marcie
authors.initials: M
authors.lastname: Brostoff
authors.affiliation: Clinical Education and Informatics, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Altavilla
authors.affiliation: Department of Pharmacy, Sidra Medical and Research Center, Al Dafna, Doha, Qatar.
authors.forename: A L
authors.initials: AL
authors.lastname: Patterson
authors.affiliation: Department of Medicine, Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Marvin B
authors.initials: MB
authors.lastname: Harper
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D059065:Medication Reconciliation / Q000379:methods*; D010343:Patient Admission / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
keywords: medical errors; patient safety, adverse events; patient safety, quality improvement; quality management, children; setting of care; specific populations, hospital care