Implementation of a Quality Improvement Project for Medical Reconciliation: Outcomes in a Primary Care Residency Clinic

Background: Medication reconciliation is the process of creating the most accurate list of medications a patient is taking and comparing it against the physician’s admission, and discharge orders. It is an effective intervention to prevent drug-related events which are the leading cause of medical errors. Medical reconciliation training promotes patient safety and is imperative for a better transition of care. Methods: We implemented a quality improvement project to promote awareness of medication reconciliation. We aimed to increase compliance of medication to 80% in 3 months and maintain it through March 2021. Our interventions consisted in reminders to prompt residents to perform medication reconciliation. As an independent reviewer, our clinic manager shared a monthly metric reports for the number of missed medication reconciliations. Results: Prior to our intervention, our percentage of medication reconciliation was 62% (August 2020). Following our intervention, the compliance increased to 82% in November 2020 and, in December, it peaked at 90%. At the end of our intervention, medication reconciliation plateaued at 85% (April 2021). Conclusions: Our quality improvement project increased resident and staff awareness of medication reconciliation. We maintained medication reconciliation above 80% from January 2021 to March 2021. In addition, we identified barriers in the process that were not recognized before including issues related with equipment, workflow and environment. Our intervention allowed for accountability because residents were monthly informed about their own performance. Our initiative allowed for development and self-improvement during training which, ultimately, might result in less medical errors