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Medication Reconciliation and Health Care Accountability

Take only as directed. It’s a warning that’s easy to follow. But what happens when physicians transfer a patient’s care to another provider without knowing what medications that patient has already been prescribed? Serious injury and even death can occur when transitions in care leads to uninformed medication orders. To combat these complications, the medical community has been implementing Medical Reconciliation, a process to compare a patient’s medications across caregivers and pharmacies in order to identify duplications, interactions between medications, and whether patients should continue taking current medications.

Medical Reconciliation should be implemented whenever there is a transition in care where new medications are ordered or existing orders are rewritten. A care transition may include changes in setting, service, practitioner, or level of care. For example, a patient’s daily medication may be suspended during a hospital stay, and the need to restart the medication upon discharge may be overlooked. Or a dosage has been mis-transcribed and when a new physician assumed care, the patient was overdosed and seriously injured. Medical Reconciliation attempts to prevent discrepancies like this.

The process of Medical Reconciliation includes
· Developing a list of current medications · Developing a list of medications to be prescribed · Comparing the medications on the two lists · Making clinical decisions based on the comparison; and · Communicating the new list to appropriate caregivers and the patient.

For newly hospitalized patients, care providers should obtain and verify the patient’s medication history, documenting that medication history, writing orders for the hospital medication regimen, and creating a medication administration record. Once a patient is discharged, care providers should determine the post-discharge medication regimen, develop discharge instructions for the patient for home medications, educate the patient, and transmit the medication list to the follow-up physician. For patients who aren’t in hospital care, the care provider should document a complete list of current medications and update that list whenever medications are added or changed. The Joint Commission requires that any accredited institution treating patients should have a process in place for Medication Reconciliation.

Medication Reconciliation and Tort Law
Even though most facilities have incorporated a Medical Reconciliation process, caregivers may not adhere fully to that policy. There is still a risk for miscommunication during the transfer process, transcription errors, and incorrect medication histories. When a patient is harmed by errors like these, lawsuits can be a particularly powerful way to hold caregivers accountable.

In some states, laws prevent patients who are harmed from filing lawsuits in certain instances. In Virginia, for example, legislation established a state fund to compensate babies born with brain injuries and prevents families from seeking damages in courts. But lawsuits require explanations from negligent health care providers and help to keep them accountable.

Filing lawsuits against negligent physicians can have a bad rap. Sometimes these suits are seen as frivolous. But in reality, only 6% of incoming civil cases are tort cases, and on average, medical malpractice cases represent only 0.6% of all incoming civil cases. In comparison, 70% of civil cases are contracts-based.

If you or someone you know has been injured due to a physician’s negligence, you don’t need to feel like filing a lawsuit makes you a “sue-happy” person. Rather, lawsuits are vital to both compensating you for your injuries and holding physicians and other caregivers accountable for their actions. The malpractice lawyers at Levin and Perconti are experienced in representing people who have been injured by negligent healthcare providers.

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