- Table of Contents
- Introduction
- Learning Objectives
- What is Medication Reconciliation?
- What is the Impact of Medication Reconciliation?
- Who Should be Involved in Medication Reconciliation?
- How to Obtain the Best Possible Medication History (BPMH)
- How to Identify and Reconcile Discrepancies
- Medication Reconciliation at Transfer
- Medication Reconciliation at Discharge
- Final Summary
- Appendices
- Appendix 1: Patient’s Guide to Medication Reconciliation, University Hospital Network
- Appendix 2: Best Possible Medication History Interview Guide
- Appendix 3: Sample BPMH Form
- Appendix 4: Sample BPMH Form from Kingston General Hospital
- Appendix 5: Sample BPMH and Admission Order Form, Capital Health, Nova Scotia
- Appendix 6: Example of a Prescription Showing the Best Possible Discharge Plan
- Appendix 7: Example of Letter to Community Pharmacist Showing BPMDP
- Appendix 8: Example of a Medication Chart for the Patient Showing the Best Possible Discharge Plan
- References
Medication Reconciliation: A Learning Guide
