Team-Based Approach to Improving Medication Reconciliation Rates in Family Medicine Residency Clinics

ABSTRACT Objective The objective of this quality improvement project was to design and implement a systematic team-based care approach to medication reconciliation with a goal of physician documented medication reconciliation at 70% of all patient office visits. Setting Ambulatory clinics located in urban, underserved communities in Minneapolis/St.Paul, MN. Practice description Four family medicine residency clinics with pharmacists integrated at each site. All clinics use Epic electronic medical record. Practice innovation A team-based care approach to medication reconciliation was designed and implemented involving medical assistants (MAs), physicians, and pharmacists. The MAs did an initial review with patients, physicians addressed discrepancies, and difficult situations were escalated to the pharmacist for detailed assessment Evaluation The percent visits with physician documented medication reconciliation was measured pre-intervention and then for 18 months post-intervention in 6 month intervals involving over 118,000 patient visits. Satisfaction surveys of team members were done pre and post intervention. Results The percent of visits with physician documented medication reconciliation improved significantly from 6.5% pre-intervention to 58.7% (p Conclusion A team-based care approach to medication reconciliation was successfully implemented and sustained in four family medicine clinics. There was significant improvement in provider documented medication reconciliation. Future studies need to address whether this process improves medication list discrepancies, completeness, and accuracy.