ED Accreditation Update

Meds reconciliation: Breathe a sigh of relief

After years of lobbying by emergency medicine groups and a summit last fall to take a closer look at the issue, a significant change has been made in the National Patient Safety Goal concerning medication reconciliation for 2009. ED managers welcome the change.

"Now, as long as things do not change dramatically in the ED, you do not have to do an entire medication reconciliation," notes David John, MD, FACEP, director of the ED at Caritas Carney Hospital in Boston. In the new goal, the ED is included among the locations where, it is noted, new medications are used "minimally" or "of short duration." While compiling a list of meds still is important, ED providers no longer have to document the dose, route, or frequency of use for the prior meds.

"Anything that involves a tremendous amount of work in the ED, without adequate funding or staff, is counterproductive," John says. He cites the example of an elderly patient. "The meds that person is on should be known and an effort should be made to get that information, but sometimes it's impractical," he notes. "It may be 3 a.m., and the pharmacy is closed and family is not available."

Christopher Beach, MD, vice chair, Department of Emergency Medicine, at the Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital in Evanston, IL, also is pleased with the new medication reconciliation goal. "I think it's reasonable," he says.