Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation

1. Percent of Patient Record With Documented Home Medication List

   Numerator          # Patient Records With List of Home Medications
   __________       _______________________________________
   Denominator       # Records Reviewed

   • Numerator: The list of home medications is documented on the identified tool; each entry includes drug name, dose, route, and frequency. This is the minimum standard; your organization may establish a higher standard.
   • Denominator: Count number of records reviewed.

   Example: Records reviewed (n) = 10

   • 5 records have a list of home medications documented on the identified tool.
   • 2 are missing the identified tool.
   • 3 have the tool, but one or more entries are incomplete, such as lack of name, dose, route, and frequency.

   Report: 50% (5/10) compliance with patient records with a list of home medications on the identified tool.

2. Percent of Medications Reconciled

   Numerator          # Patient Records With List of Home Medications
   __________       _______________________________________
   Denominator       # Records Reviewed

   Note: Of the 10 records identified in the first report, review only the 5 records with the home medication list documented in the identified tool.

   • Numerator: Count of the number of medications on the home medications list reconciled with admission orders.
   • Denominator: Count of the number of medications eligible for reconciliation. Medications that by policy are not administered within the organization are not eligible for reconciliation but should be reconciled on discharge (e.g., non-formulary products or herbal supplements).

   Example: Records reviewed (n) = 5; 80 medications were ordered on admission 

   • 10 home medications were appropriately substituted due to formulary constraints.
   • 70 home medications required reconciliation.
   • 50 medications were reconciled.

Implementation

Once you have designed and pilot tested your process and made any necessary enhancements, you are ready for facility-wide implementation of your medication reconciliation project. To carry this out, form an implementation team (which may be the same or different from your design team) and develop a plan for implementation. Below is an example implementation timeline for a hospital-wide roll out of a medication reconciliation project.