Appendix, Assembling a Medication Reconciliation Team

Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation

Identify key stakeholders that need to be aware of your efforts to improve the medication reconciliation process. Examples might include your chief executive officer, department chairs, trustees, etc. From these stakeholders, identify a leadership team and design team. Define a reporting structure.

Medication Reconciliation Leadership Team

Executive Sponsor(s):


Project Sponsor(s):


Improvement Leader(s):

 

Medication Reconciliation Design Team (from this group, select a process owner)

Physician(s):


Pharmacist(s):


Nurse(s):


Discharge Planner(s):


Information Systems:


Emergency Department Representative(s):


Patient Safety and Quality Staff:


Patient Representative (if possible):


Managers/Directors of Frontline Staff:


Department Chiefs/Chairs:


Medical Record Leader(s):


Quality, Licensure, and Accreditation Representative:


Frontline Staff:


Quality Committee Representative(s):


Other:

 

Reporting Mechanism (especially to whom/where the team will report)

Reporting structure:

 

 

 

 

 

Frequency:

 

Medication Reconciliation Team Roster

Executive Sponsor(s):NameEmail
(Member of leadership)PhonePager
Project Sponsor(s):NameEmail
 PhonePager
Improvement Leader(s):NameEmail
 PhonePager
Physician(s):NameEmail
 PhonePager
Pharmacist(s):NameEmail
 PhonePager
Nurse(s):NameEmail
 PhonePager
Discharge Planner(s):NameEmail
 PhonePager
Information Systems:NameEmail
 PhonePager
Emergency Department
Representative(s):
NameEmail
 PhonePager
Patient Safety and Quality Staff:NameEmail
 PhonePager
Managers/Directors of Frontline Staff:NameEmail
 PhonePager
Department Chiefs/ Chairs:NameEmail
 PhonePager
Medical Record Leader(s):NameEmail
 PhonePager
Quality, Licensure, and Accreditation:NameEmail
 PhonePager
Frontline Staff:NameEmail
 PhonePager
Quality Committee Representative(s):NameEmail
 PhonePager
Page last reviewed August 2012
Internet Citation: Appendix, Assembling a Medication Reconciliation Team: Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation. August 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/match/matchap2.html