Medication adherence post transplantation is vital. Upon discharge, abdominal transplant patients receive a medication list from the electronic medical record (EMR) and obtain a medication teaching tool that includes pictures of medications (Medication Action Plan (MAP)). Patients typically rely on the MAP for their medication schedule post-transplant. This MAP does not communicate with the EMR and there are often discrepancies between these lists. Multiple providers are involved in medication education and documentation which can create additional variation in medication lists. Medication reconciliation discrepancies on discharge may lead to medication errors and patient harm.

In 2016, an average of 4.9 medication discrepancies per patient were identified between the MAP and electronic medication list in 51 patients. A quality improvement project was undertaken to decrease the discrepancy rate. Overall, we analyzed the medication records from 103 post abdominal transplant patients that were discharged between March of 2016 and July of 2017. The tests of change (TOC) included: 1. More providers given access to MAP. 2. PharmD provided MAP to discharge provider. 3. Discharge RN role created 4. Inpatient coordinator position was created and an additional discharge RN position was created. The outcome measured was the percent of patients with no discrepancies between medications lists.

On average, patients were taking 17 medications daily. The most common types of discrepancies found before implementing the test of change were: omission (27%), dose (23%), schedule (15%), and strength(11%). After implementation of the tests of change, the most common discrepancies included dose (50%), omission (18%), and commission (16%). Prior to implementation of the quality initiative, there were 3% of medication profiles with no discrepancies between the medication list. The tests of change did increase the rate of medication lists without discrepancies. The TOC #1 yielded a 3.7% rate, TOC #2 yielded a 22% rate, TOC #3 yielded a 27% rate, and TOC #4 yielded a 47% of medication lists without discrepancies. Assigning specific roles has helped decrease medication discrepancies. Process change is sustainable. Exploration of the optimal role and process continues.

CITATION INFORMATION: Todd S., Perryman J., Subramanian R., Patel A., Hawthorne M., Buenvenida R., Lee K., Allison W., Lo D., Reshamwala P. Medication Reconciliation in Abdominal Transplantation Am J Transplant. 2017;17 (suppl 3).

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