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A Toolkit to Disseminate Best Practices in Inpatient Medication Reconciliation: Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS)

      Transitions of care, such as those that occur at hospital admission and discharge, are vulnerable times for patients with respect to medication safety.
      • Coleman E.A.
      • et al.
      Posthospital medication discrepancies: Prevalence and contributing factors.
      • Smith J.D.
      • Coleman E.A.
      • Min S.J.
      A new tool for identifying discrepancies in postacute medications for community-dwelling older adults.
      • Cua Y.M.
      • Kripalani S.
      Medication use in the transition from hospital to home.
      Medication errors are common during these times of transition, resulting from a number of factors, including discontinuity of providers and information,
      • Forster A.J.
      • et al.
      The incidence and severity of adverse events affecting patients after discharge from the hospital.
      • Kripalani S.
      • et al.
      Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists.
      • Kripalani S.
      • et al.
      Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care.
      multiple changes in medication regimens,
      • Kripalani S.
      • et al.
      Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists.
      • Beers M.H.
      • et al.
      Influence of hospitalization on drug therapy in the elderly.
      • Omori D.M.
      • Potyk R.P.
      • Kroenke K.
      The adverse effects of hospitalization on drug regimens.
      • Schachtner J.M.
      • et al.
      Prevalence and cost savings of therapeutic interchange among U.S. hospitals.
      rushed discharge processes,
      • Kripalani S.
      • et al.
      Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists.
      and inadequate or ineffective patient/caregiver counseling.
      • Forster A.J.
      • et al.
      The incidence and severity of adverse events affecting patients after discharge from the hospital.
      • Bond C.A.
      • Raehl C.L.
      Clinical pharmacy services, pharmacy staffing, and adverse drug reactions in United States hospitals.
      • Makaryus A.N.
      • Friedman E.A.
      Patients’ understanding of their treatment plans and diagnosis at discharge.
      • Calkins D.R.
      • et al.
      Patient-physician communication at hospital discharge and patients’ understanding of the postdischarge treatment plan.
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