Health Leaders recently reported that a new discharge checklist to improve discharge summaries and medication reconciliation implemented at the Cleveland Clinic increased the main campus’ completion rate for medication reconciliation from 88% to 98.7% and increased the completion rate for discharge summaries from 58% to 80%.

The medication reconciliation document is a mandatory step in the Cleveland Clinic’s discharge process, which was implemented in November 2018.

“It’s a hard stop,” said Amy O’Linn, DO, a hospitalist and physician lead for enterprise readmission reduction at Cleveland Clinic. “The patient cannot leave the campus until the medication list is signed off by the primary care team.”

The discharge summary, which is not absolutely required to discharge a patient, is made up of 18 elements, including admission date, discharge date, chief primary complaint when the patient came to the hospital, discharge disposition and the medication list.

O’Linn said a primary barrier to the discharge checklist was fear among clinicians. “People were afraid that if we made a hard stop for the medication reconciliation, then patients would never leave the hospital. After we worked through the process for a couple of months, we came out knowing we could do this. It did not affect the length of stay. The day we launched, we were nibbling our fingernails, but we never got a call. We had all lines open to help people who had trouble, but everything was OK.”

Access the Health Leaders article.

Medication reconciliation to ensure a complete and accurate medication list at each transition of care is a best practice that occurs in all healthcare settings. For the medication list to be complete and accurate, it must include the indication or diagnosis for each medication on the list. A complete and accurate medication list included in the hospital discharge summary is important when the patient transitions to another healthcare setting, including the primary care provider and post-acute settings. The patient and family must have an understanding of the prescribed medications and why they are taking each medication. Patient lack of knowledge about their medications, how and why they take them may lead to an ED visit or potentially avoidable readmission.

Great Plains QIN is partnering with communities throughout the region to unite stakeholders, consumers and healthcare providers to improve communication and care coordination – resulting in reduced hospital admissions, readmissions and medication harm. For more information on how medication safety and medication management play an integral role in care coordination, visit the Medication Safety Initiative page of our site.