Aggravated DocSurg wrote about the unintended consequences of Joint Commission’s medication reconciliation standards. Read his post and what his commenters had to say here.
The medication reconciliation initiative was driven by the realization that the most serious medication errors occur at the transitions of care rather than within an episode of care. The solution seemed simple and obvious. Why did it turn out to be such a morass? Several reasons, perhaps. The reconciliation can never be any better than the input from the person who makes the initial assessment. If it gets messed up at the beginning the errors tend to be perpetuated throughout the encounter and beyond because the form is sacred. Reliance on the form can be a substitute for thoughtful attention to detail.
A couple of years I was enthusiastic about the idea. Unfortunately it has proven to be dysfunctional in the real world.