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

Appendix, Assembling a Medication Reconciliation Team

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): Name Email
(Member of leadership) Phone Pager
Project Sponsor(s): Name Email
  Phone Pager
Improvement Leader(s): Name Email
  Phone Pager
Physician(s): Name Email
  Phone Pager
Pharmacist(s): Name Email
  Phone Pager
Nurse(s): Name Email
  Phone Pager
Discharge Planner(s): Name Email
  Phone Pager
Information Systems: Name Email
  Phone Pager
Emergency Department
Representative(s):
Name Email
  Phone Pager
Patient Safety and Quality Staff: Name Email
  Phone Pager
Managers/Directors of Frontline Staff: Name Email
  Phone Pager
Department Chiefs/ Chairs: Name Email
  Phone Pager
Medical Record Leader(s): Name Email
  Phone Pager
Quality, Licensure, and Accreditation: Name Email
  Phone Pager
Frontline Staff: Name Email
  Phone Pager
Quality Committee Representative(s): Name Email
  Phone Pager
Page last reviewed August 2012
Internet Citation: Appendix, Assembling a Medication Reconciliation Team. 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