I see folks all the time who have returned to Florida for the winter months or were hospitalized.
It's always great when they bring in copies of their medical records.
Almost every medical document now includes the words "medications reconciled" or "see discharge instructions for medication reconciliation."
What seems to be lacking, however, is a careful review of the medications and the instructions for use.
The computer generated print outs look impressive.
Reviews can reveal many errors.
Often, for example, one beta blocker was substituted for another beta blocker during the hospitalization but both still appear on the discharge medication reconciliation sheet.
Obviously, this can lead to adverse medication effects and/or the need for a repeat hospitalization.
Had a nice man recently return from up north, having been hospitalized just prior to returning, for new onset diabetes mellitus.
He was confused what dose of insulin he should take.
His medication reconciliation sheet had the following instructions (re-typed exactly as written):
Lantus 100 units/ml subcutaneous solution. Directions for use: 60 units subcutaneous of lantus a day (at bedtime), once blood sugar <100 decrease to 30 units of lantus, once BS < 100 decrease to 15 units of lantus, once blood sugar <100 discontinue lantus, X 30 days
He was discharged by a board certified endocrinologist.
The instructions were as clear as mud.
Easy rule: if a health care professional can't understand the instructions, it's appropriate to assume that our patients can't either.
A lot of computer generated signatures are entered on documents that have not been carefully read. The medication reconciliation page is one that needs to be carefully reviewed before signing.