Overview of Medication Reconciliation

Medication reconciliation is a high priority for both patient safety and accreditation. The Pre-Admission Medications List (PAML) is a tool with several purposes:

• Gathering and verifying a complete record of the medications a patient has been taking before admission

• Indicating if and how those medications will be administered during the inpatient visit

• Presenting those medications for consideration when writing inpatient orders

• Presenting those medications for processing at discharge

The pre-admission medication list is one of the documents required for medication reconciliation. It should be used to facilitate communication with the patient, family, and any caregivers who can provide information on the patient's medications prior to admission.

The PAML Builder is accessible for all inpatients, including those with orders on paper who do not have electronic orders in Order Entry.

• All medications except those flagged to hold or discontinue should have a corresponding medication order written in MGH Provider Order Entry. Medications may be held for the entire visit, or until completion of a procedure—write the orders as appropriate to the course of care. Medications may be held for the entire visit, or until completion of a procedure-write the orders as appropriate to the course of care. These medication orders are NOT written automatically when the medications are recorded in the PAML.

• See Also:

• Guidelines for Medication Reconciliation

• PAML Quick Tips

• Overview of the PAML Builder

• Building the Pre-Admission Medication List

• Writing Inpatient Medication Orders From the PAML

• Writing Post-Op Medication Orders From the PAML

• Continuing or Resuming  Medications For Discharge

• Reviewing Medications at Discharge (Nursing)

• Demonstrations:

• Medication Reconciliation For MDs, NPs, PAs, and CNMs

• Medication Reconciliation For RNs

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