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Table 4 Standardized MedRec Auditing Tool

From: Avoiding a Med-Wreck: a structured medication reconciliation framework and standardized auditing tool utilized to optimize patient safety and reallocate hospital resources

Auditing questions MedRec score (yes = 1; no = 0)
Was an accurate BPMH obtained on admission?  
Was an accurate BPMH obtained on internal transfer? (If N/A = score of 1)  
Was an accurate BPMH documented at discharge?  
Were discrepancies between BPMH and medication administration record (MAR) record identified and resolved within 24 h of admission?  
Were discrepancies between BPMH and MAR identified and resolved at discharge?  
Were formulary/non-formulary auto-substitutions in the hospital reverted to what the patient was taking prior hospitalization? (If N/A = score of 1)  
Was a standardized discharge report (i.e., new, continued, stopped, and/or changed medications) faxed to the patient’s primary pharmacy?  
Did the patient receive a PODS at discharge?  
Was the patient counselled by pharmacist on all medications (including monitoring) at discharge?  
Was cost of medications and insurance coverage discussed and addressed with the patient?  
Is there a mechanism of communication between community pharmacist, family physician, and hospital physician?  
MedRec Score (out of 11)  
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