1. Patient Safety …. Don’t get sick in July…..

2. What Can I do as a Medical Student?

3. What you can do 0 Be a patient advocate 0 Pay attention 0 Ask questions

4. Medication Reconciliation 0 Take this on this year…..

5. Reconciliation? Bringing together, making “right”

6. What is medication reconciliation? 0 "the process of comparing a patient's medication orders to all of the medications that the patient has been taking. “

7. Why? 0 Avoid medication errors: 0 Omissions 0 Duplications 0 Dosing errors 0 Drug interactions

8. When? 0 Every transition of care in which new medications are ordered or existing orders are rewritten. 0 Transitions in care: 0 Changes in setting, service, practitioner or level of care 0 Patient moves from one unit to another 0 Patient moves from one service to another 0 Patient is admitted to the hospital 0 Patient is discharged from the hospital 0 Patient enters or leaves rehab, assisted living, or nursing home 0 Patient changes physicians 0 Patient sees new physician (subspecialist) in consultation

9. 5 Steps: 0 Develop a list of current medications 0 Develop a list of medications to be prescribed 0 Compare the medications on the two lists 0 Make clinical decisions based on the comparison 0 Communicate the new list to appropriate caregivers and to the patient.

10. Your part… 0 Review medication profile with the patient to assure it is correct and up-to-date 0 Discontinue all non-active medications 0 Renew all expired medications 0 Prescribe new medications not on the medication profile including OTC, herbal, and traditional medications 0 All prescriptions will contain the indication for prescribing (to address health literacy)

11. Next part… 0 Patient needs to receive a copy of the list: 0 In real words 0 No abbreviations 0 Think about health literacy 0 Write out indication for each medication 0 Include in the medical record: At UNC, help to update the medication list in WebCis….

12. When can you help? 0 At admission: 0 Pharmacists will be in ED to help with obtaining accurate medication lists on patients being admitted: Emergency Department Pharmacy Technician Team 0 7 am-10 pm Mon-Friday 0 9 am- 5 pm Saturday, Sunday, holidays 0 Contact information on handouts and on website ….

13. At Discharge 0 Students often initiate creation of the discharge summary 0 Medication Reconciliation crucial! 0 Go through home medications (use information obtained from ED team, yourself, family, patient, facility) 0 Go through current medications in hospital 0 Justify use of each medication 0 Make sure no duplications 0 Use Generic names!!! 0 Update medication list in WebCis 0 Specify what changes were made and why!

14. Patient Safety…. 0 What can you do? Take this on, improve quality of care, and ….

15. And… 0 Become the MVS (Most Valuable Student) for the team!