Assessing the Severity of Potential Harm of Errors Intercepted by Medication Reconciliation on Admission in an Emergency Care Unit

Background: Medication reconciliation (MR) at hospital admission retroactively allows the interception and correction of errors by comparing the initial hospital prescription with the patient's medication list; this list or best possible medication history being obtained by crossing various sources. This study aimed to assess the severity of potential harm of errors intercepted by MR on admission to emergency care unit. Method: The potential severity of the intercepted errors was assessed using a clinical algorithm considering two ways: considering the hospital stay only and regardless of duration; as if the error remained unresolved post discharge from hospital. These errors were positioned by a five-point scale rating their potential to cause harm: minor, significant, major, critical and catastrophic. Results: MR of 122 patients revealed 461 medications errors. The three most common classes involved were cardiovascular system (N = 151, 32%), nervous system (N = 103, 22%) and gastrointestinal (N= 86, 18%) medications. The most common types of errors were omission (N= 381, 83%) and incorrect dose (N= 57, 12%). Among the errors intercepted, 1.1% had potential major clinical consequences if we considered the hospital stay and 8.5% were ranked major or critical if they remained unresolved post discharge from hospital. Conclusion: The assessment of the potential harm of medication errors reflects the clinical interest of the MR. This evaluation revealed a potential clinical impact in emergency care unit previously unknown by the medical teams.