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Hospital to Home - Facilitating Medication Safety at Transitions

A Toolkit and Checklist for Healthcare Providers

It's time that medication regimens are communicated clearly at transitions to patients, caregivers, and the next providers of care.

Hospital discharge is a critical interface when patients are at high risk of fragmented care, adverse drug events, and medication errors as they transition out of the hospital to their home environment. Ensuring safe medication transitions is complex and requires an interdisciplinary team effort.

The goal of using a medication-focused transition checklist is to increase patient safety by reducing medication errors and incidents that occur when a patient transitions from hospital to home.

Developed with support from the Ontario Ministry of Health and Long-Term Care.


(includes the Checklist)
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Hospital to Home: Facilitating Medication Safety at Transitions Poster Presentation, 2016

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"... was really helpful for getting discharge medication lists to the service providers, like myself in a timely manner. Not having a discharge medication list can be troublesome especially if there are cognitive challenges and/or poor patient support in the home, or no family doctor."
CCAC Rapid Response Nurse

"... one of the most rewarding parts of my job is improving the patient's understanding of their medications and to help them feel more confident about taking their medications when they go home. The checklist prompts me to systematically go through each step so that the medication information we send with the patient and to their healthcare providers is accurate and complete. It's about passing the baton to ensure the patient can succeed at home."
Clinical pharmacist

"A superb, comprehensive guide to implementing effective medication reconciliation, which is a key component of high quality healthcare transitions."
Dr. Kenneth Boockvar