Medication Reconciliation at Discharge

Pre-admission and inpatient medication name, dose, frequency, route, and PRN status (yes or no, not reason) are identical

Color-flagged parameters in pre-admission medication differ from inpatient medication with matching ingredient, route, and form

Color-flagged parameters in inpatient medication differ from pre-admission medication with matching ingredient, route, and form

Bold med name

PAML or inpatient medication has not been reconciled (check Yes or No to reconcile)

Color-flagged parameters in discharge medication included from pre-admission medication and/or inpatient medication differ from the source

Click  to enlarge Medications to Reconcile pane

Click to restore Medications to Reconcile pane to the top 2/3 of the display

Click to enlarge the Discharge Medication List pane

Click to restore Discharge Medication List pane to the bottom third of the display

Medication selected; when picked on the discharge list, source in pre-admission and/or inpatient lists are also highlighted

Status—X of Y medications reconciled where:
 X = total of inpatient orders and pre-admission records with Yes or No selected (count as 1 when the inpatient/pre-admission
  medication name, dose, frequency, route, and PRN status—yes or no, not reason—are the same )
 Y = total of inpatient orders and pre-admission records needing reconciliation

Links

<I>

Instructions (for care providers); hold the mouse pointer over underlined text to display details

<R>

PRN (as needed) reason(s); hold the mouse pointer over underlined text to display details

Click to select a medication from the PAML, inpatient, or discharge lists, then click to open Knowledge Link