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Unintentional medication discrepancies during transitions in care (such as hospitalization and subsequent discharge) are very common and represent a major threat to patient safety. One solution to this problem is medication reconciliation. In response to Joint Commission requirements, most hospitals have developed medication reconciliation processes, but some have been more successful than others, and there are reports of proforma compliance without substantial improvements in patient safety. There is now collective experience about effective approaches to medication reconciliation, but these have yet to be consolidated, evaluated rigorously, and disseminated effectively.

In 2010, the Agency for Healthcare Research and Quality (AHRQ) awarded the Society of Hospital Medicine (SHM) a $1.5 million grant for a three-year Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS). The goal of MARQUIS is to develop better ways for medications to be prescribed, documented, and reconciled accurately and safely at times of care transitions when patients enter and leave the hospital.

Role of the Hospitalist:

  • Take responsibility for the accuracy of the medication reconciliation process for each patient under your care.
  • Lead, coordinate, or participate in medication reconciliation quality improvement efforts along with other key team members on the "front lines" to inform the hospital QI team on key interventions that would lead to improved patient outcomes.
  • Become trained in taking the “best possible medication history” and effective discharge medication counseling.
  • Identify patients who are at high risk for a medication reconciliation error and would benefit from a more intensive medication reconciliation process.


Funded by AHRQ grant HS0195898
MARQUIS Project Team


MARQUIS: Medication Reconciliation Implementation Manual

Education and Training

Best Possible Medication History (BPMH) Certification


SHM White Paper - Medication Reconciliation: A Team Approach


Taking a Good Medication History Video

Best Possible Medication History (BPMH) Pocket Cards

Good Discharge Counseling Video

ROI Calculations

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