Home Medication Lists

Question:

Most of our hospitals have a modified process for medication reconciliation for outpatient areas.   In most cases, patients are only given prescriptions for pain meds and antibiotics and no changes are made to the home medication lists.

A couple of our hospitals are not providing a reconciled medication list at discharge.   My question is how this is surveyed.  The Joint Commission allows a modified process for outpatient, however, is there an expectation to provide a reconciled medication list even if it is just the home medication list that has “No changes Made” and the medication list includes the new prescription/prescriptions? 

Answer:

In select outpatient settings where there will be no adjustment of the patients existing medication list, you would not have to reprint an entire medication history and provide it to the patient. If any new, short-term medications are prescribed clear instructions should be provided on how to take those medications. 

On the inpatient side when the surveyor reviews the discharge instructions, they will typically look for the medication list.  We normally see the home medication list as a routine part of the EMR after-visit summary or discharge instructions.  When discharged after an inpatient stay, you don’t have the option to skip this written list. While it is common to not change a home medication list after a brief outpatient visit, the inpatient visit has very often changed brands or made therapeutic substitutions, added and deleted home medications, so a fully reconciled list is required at discharge.