Table 4 Time to complete medication reconciliation tasks at discharge per hospital unit

Preparing the discharge prescription

21

29.0 (23.8)

5.2

91.7

21

19.4 (11.7)

1.2

44.0

20

9.9 (18.2)

1.9

84.0

  Reviewing in-hospital medications

19 (90.5)

2.4 (1.5)

0.1

6.2

18 (85.7)

2.4 (2.2)

0.0

8.1

15 (75.0)

2.2 (2.0)

0.3

7.8

  Reviewing community medications or chart notes

18 (85.7)

1.9 (1.0)

0.6

4.4

11 (52.4)

2.3 (2.4)

0.2

8.5

9 (45.0)

1.4 (1.5)

0.2

5.2

  Self-reported time^a

1 (4.8)

5 (.)

5.0

5.0

3 (14.3)

4.7 (3.5)

1.0

8.0

0 (0.0)

  Discussing community medications with patient

0 (0.0)

1 (4.8)

1.4 (.)

1.4

1.4

0 (0.0)

  Discussing the discharge prescription with patient

4 (19.0)

20.0 (13.4)

7.4

38.8

6 (28.6)

5.1 (2.7)

2.5

8.4

3 (15.0)

25 (43.0)

0.2

74.7

  Consulting with other health professionals about the discharge prescription

14 (66.7)

5.3 (7.4)

0.0

27.7

13 (61.9)

5.3 (4.2)

0.1

15.5

5 (25.0)

1.8 (1.8)

0.2

4.2

  Writing the discharge prescription

21 (100.0)

7.1 (6.5)

0.4

23.7

21 (100.0)

5.5 (3.9)

1.1

19.7

19 (95.0)

3.4 (2.6)

0.6

9.4

  Reviewing the discharge prescription

17 (81.0)

4.7 (2.8)

1.0

11.4

16 (76.2)

4 (4.9)

0.1

19.9

2 (10.0)

0.7 (0.3)

0.6

0.9

  Revising the discharge prescription after consulting other clinicians

7 (33.3)

1.6 (1.6)

0.0

4.8

3 (14.3)

1.3 (1.9)

0.1

3.5

0 (0.0)

  Revising the discharge prescription after consulting the patient

1 (4.8)

1.5 (.)

1.5

1.5

0 (0.0)

0 (0.0)

  Other final documentation

4 (19.0)

29.8 (12.7)

19.3

48.0

1 (4.8)

0.8 (.)

0.8

0.8

1 (5.0)

1.6 (.)

1.6

1.6

  Faxing discharge information to pharmacy

2 (9.5)

3.8 (3.8)

1.1

6.5

4 (19.0)

9.9 (6.5)

2.3

16.2

0 (0.0)