Medication reconciliation: A qualitative analysis of clinicians' perceptions

Background: Medication reconciliation has been at the forefront of national patient safety efforts for nearly a decade, yet health care institutions remain challenged with implementation.

Objectives: The objective of this article was to report an analysis of a qualitative study of the experiences of physicians, nurses, and pharmacists with medication management practices, specifically focusing on the practice of medication reconciliation.

Methods: This study used focus groups in a qualitative approach to explore participant perceptions about interprofessional communication and adverse drug events. Three focus groups were conducted at each of 3 Veterans Administration hospitals, 1 each for physicians (13), nurses (19), and pharmacists (16). The analysis for this article focused on specific discussions about medication reconciliation.

Results: Two primary thematic questions emerged from the discussion about medication reconciliation: What does medication reconciliation really mean? Who is actually responsible for the process? Participants from each profession had differing perspectives about the purpose and processes of medication reconciliation. Perceived responsibilities appeared to be influenced by their distinct views regarding the meaning and purpose of medication reconciliation. The pharmacist role emerged as a critical role to assure medication safety.

Conclusions: Translating the intent of medication reconciliation into effective practice requires acknowledgment of the involved professionals' diverse perspectives on the independent, joint, and overlapping functions of medication management as well as recognizing the limitations of technology.