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Reducing Discrepancies in Medication Histories and Orders at Handoffs

Gary Noskin, M.D., Northwestern University, Evanston, IL AHRQ Grant No. HS015886-01


This project implements a single, shared, updated and reconciled medication and allergy list for patients across the continuum of inpatient and outpatient care. A central component of this intervention is the development of objective criteria for use in the hospital inpatient, primary care, or home health outpatient settings to trigger pharmacist review and involvement in taking the patient's medication history. The toolkit includes:

  • Clinician training tools in medication reconciliation.
  • Medication and allergy lists for reconciliation.
  • Criteria for pharmacist consultation and review of medication history.
  • Patient education tools.
  • Resources geared toward successful implementation, such as institutional review board forms and scripts for patient and staff focus groups.

Target Audience

Physicians, nurses, pharmacists, quality and safety professionals, patients, caregivers.

Health Care Setting

Hospitals, pharmacies, outpatient facilities.

Toolkit Web Site

Press Releases

AHRQ Awards More Than $8 Million To Further Implementation of Evidence-Based Patient Safety Findings
June 8, 2005

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Page last reviewed October 2004
Internet Citation: Reducing Discrepancies in Medication Histories and Orders at Handoffs. October 2004. Agency for Healthcare Research and Quality, Rockville, MD.


The information on this page is archived and provided for reference purposes only.


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