From: Medication reconciliation at admission and discharge: a time and motion study
Medication reconciliation tasks | Geriatrics | Internal medicine | ||||||
---|---|---|---|---|---|---|---|---|
 | Time (minutes) |  | Time (minutes) | |||||
N (%) | Mean (SD) | Min | Max | N (%) | Mean (SD) | Min | Max | |
Overall | 21 | 92.2 (44.3) | 46.1 | 202.5 | 20 | 46.2 (21.1) | 22.5 | 94.6 |
Prior to meeting the patient | 19 (90.5) | 29 (22.2) | 6.9 | 91.7 | 20 (100.0) | 16.3 (9.3) | 7.1 | 36.8 |
  Reading medical chart | 19 (90.5) | 20.8 (18.6) | 0.4 | 75.6 | 20 (100.0) | 13.1 (8.1) | 5.6 | 32.4 |
  Reviewing lab results | 19 (90.5) | 7.8 (4.3) | 3.4 | 21.3 | 20 (100.0) | 3.2 (1.6) | 1.0 | 7.0 |
  Calculations | 8 (38.1) | 1 (0.6) | 0.5 | 1.8 | 2 (10.0) | 0.2 (0.0) | 0.2 | 0.2 |
Discussion with patient a | 21 (100.0) | 13.4 (9.1) | 0.6 | 31.0 | 20 (100.0) | 5.2 (4.0) | 1.1 | 15.5 |
  Introduction | 21 (100.0) | 4 (3.3) | 0.3 | 11.6 | 19 (95.0) | 1.4 (2.1) | 0.1 | 8.3 |
  Community drug list | 19 (90.5) | 3.7 (3.3) | 0.1 | 11.5 | 19 (95.0) | 1.7 (1.8) | 0.1 | 6.4 |
  Medication knowledge | 10 (47.6) | 1.9 (1.5) | 0.5 | 5.1 | 4 (20.0) | 0.2 (0.3) | 0.1 | 0.6 |
  Medication posology | 12 (57.1) | 1.9 (1.6) | 0.3 | 5.1 | 9 (45.0) | 0.6 (0.4) | 0.2 | 1.5 |
  Adherence to medication | 7 (33.3) | 0.8 (0.4) | 0.3 | 1.5 | 4 (20.0) | 0.2 (0.2) | 0.0 | 0.5 |
  Over-the-counter medication | 15 (71.4) | 3.5 (2.5) | 0.5 | 7.9 | 14 (70.0) | 0.9 (0.9) | 0.1 | 3.6 |
  Allergies | 14 (66.7) | 0.9 (0.7) | 0.2 | 2.9 | 11 (55.0) | 0.2 (0.2) | 0.1 | 0.7 |
  Pharmacy coordinates | 12 (57.1) | 0.8 (0.5) | 0.2 | 1.6 | 17 (85.0) | 1.3 (2.7) | 0.3 | 11.7 |
  Permission to exchange medication information | 7 (33.3) | 0.7 (0.7) | 0.1 | 1.8 | 9 (45.0) | 0.2 (0.3) | 0.0 | 1.0 |
External research on medication history b | 19 (90.5) | 13 (11.9) | 4.0 | 47.1 | 19 (95.0) | 6.2 (4.2) | 1.0 | 19.2 |
  Communication with family caregiver not in hospital | 3 (14.3) | 9.7 (4.8) | 4.2 | 12.6 | 2 (10.0) | 3.4 (3.4) | 1.0 | 5.8 |
  Communication with Community Service Centre/nursing home | 1 (4.8) | 6.4 (.) | 6.4 | 6.4 | 1 (5.0) | 2.1 (.) | 2.1 | 2.1 |
  Searching for pharmacy coordinates | 11 (52.4) | 5.1 (7.9) | 0.5 | 28.3 | 11 (55.0) | 3 (2.1) | 0.4 | 5.5 |
  Communication with the pharmacy | 19 (90.5) | 8.2 (9.4) | 2.5 | 44.8 | 18 (90.0) | 4.2 (3.4) | 0.6 | 13.0 |
Reconciliation of medications and documentation | 21 (100.0) | 40.8 (20.0) | 19.0 | 85.9 | 20 (100.0) | 18.9 (15.0) | 2.5 | 57.1 |
  Clarifying discrepancies with patient | 4 (19.0) | 1.7 (1.2) | 0.1 | 3.0 | 6 (30.0) | 3.6 (3.2) | 0.6 | 9.6 |
  Documenting admission medication list | 21 (100.0) | 32.3 (17.8) | 8.8 | 64.3 | 20 (100.0) | 15.3 (11.7) | 2.3 | 45.5 |
  Discussing recommendations with in-hospital prescriber | 8 (38.1) | 3.1 (2.2) | 0.6 | 7.3 | 4 (20.0) | 2 (1.6) | 0.7 | 4.3 |
  Documenting recommendations for in-hospital prescriber | 11 (52.4) | 12.3 (10.3) | 0.1 | 38.6 | 9 (45.0) | 2.2 (1.8) | 0.4 | 5.4 |
  Other documentation | 5 (23.8) | 2 (1.0) | 1.2 | 3.7 | 4 (20.0) | 5.1 (5.0) | 0.6 | 11.6 |