Percentage Of Patients With All Steps Of Medication Reconciliation Completed And Documented On Discharge Or Transfer (Is Yes If [(2a = Y) And (2b = Y)]) Reconciliation Process on Discharge or Transfer Medication reconciliation on discharge or transfer is the formal process of: 1. Medication reconciliation Comparing the doctor's discharge or transfer orders to the medication history and ensuring that any discrepancies are brought to the attention of the prescriber and, if appropriate, changes are made to the orders. • Check the admission BPMH (as documented on the WA MMP) for any un-actioned discrepancies, • Comparing what is on the medication chart/s with medications required at discharge (to see if any medication is missing), and • Comparing the medication list on the WA MMP (once all discrepancies have been identified) with the medication list in the discharge summary. 2. Discharge liaison Ensuring that frequent and accurate communication about the patient's medications occurs between all clinicians involved in the patient's care and relevant information is also communicated to the patient and/or carer. While the measure reported refers to the overall process of medication reconciliation, the measurement of each of the individual aspects might assist hospitals to identify problem areas requiring a more targeted approach.

Number of patients with all steps completed and documented at discharge

Number of patients in sample

Over the 6 month collection period a total of 5-10 patients per ward at the hospital should be audited to ensure that data is collected from each clinical area. An audit tool has been developed by the WA Medication Safety Network to facilitate documentation - Medication Reconciliation Audit Tool. Selection of a random sample of current inpatients is recommended. Sample size will depend on available resources and facility size, but the following recommendations are based on the number of beds included in the program: 150 or more: 20% of patients 30 – 149: 30 patients Less than 30: Actual number of beds

Medication Review Reporting Form to the Department of Health. Not publicly reported based on available evidence

www.health.wa.gov.au/Articles/J_M/Medication-reconciliation www.health.wa.gov.au/~/media/Files/Corporate/general-documents/safety/PDF/1015-Med-Rec-Audit-Tool-Guidelines.pdf