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A Systems-Based Medication Reconciliation Process: With Implications for Home Healthcare

Myrka, Anne BS Pharm, MAT, BCPS; Butterfield, Sara RN, BSN, CPHQ; B., Goss J. RPh, PhD; Amin, Piyush RPh, PharmD; Ambrosy, Susan RN, MSN; Woellmer, Cynthia RN, BSN; Glock, Shelly LNHA, MBA

Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional: November-December 2011 - Volume 29 - Issue 10 - p 624–635
doi: 10.1097/NHH.0b013e31823454e5

This article describes the medication reconciliation process applied on hospital discharge of patients to home with home care services within Seton Health System, an integrated health delivery network located in Troy, New York. The project, which was not research based, was characterized by an intensive pharmacotherapeutic medication reconciliation at hospital discharge by the hospital-based pharmacist with continued pharmacist support available to home healthcare nurses collaboratively at the time of start of care and resumption of care. The goal of this process was to identify and resolve medication-related problems and reduce hospital readmissions.

Anne Myrka, BS Pharm, MAT, BCPS, is a Pharamacist at IPRO, Albany, New York.

Sara Butterfield, RN, BSN, CPHQ, is the Senior Director of Healthcare Quality Improvement at IPRO, Albany, New York.

J.B. Goss, RPh, PhD, is the Director of Pharmacy Services, Seton Health System and an Investigator at the New York State Department of Health PSC Study, Troy, New York.

Piyush Amin, RPh, PharmD, is a Medication Safety Officer at Seton Health System and St. Mary's Hospital, Troy, New York.

Susan Ambrosy, RN, MSN, is a Quality Manager at Seton Heath Home Care, Troy, New York.

Cynthia Woellmer, RN, BSN, is a Registered Nurse at Seton Health Home Care, Troy, New York.

Shelly Glock, LNHA, MBA, is a Quality Improvement Specialist at IPRO, Albany, New York.

The analyses on which this publication is based were performed under Contract Number HHSM-500–2008-NY9THC, funded by the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. The authors assume full responsibility for the accuracy and completeness of the ideas presented.

The authors have no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

Address for correspondence: Sara Butterfield, RN, BSN, CPHQ, 20 Corporate Woods Blvd., Albany, NY 12211 (

© 2011 Lippincott Williams & Wilkins, Inc.