Background Complete medication reconciliation is often difficult to achieve, particularly in the emergency department (ED). General practitioner (GP) medication lists may be used by some doctors for charting medications. Aim To determine the discrepancies in the medication history information between GP medication lists and the actual medication usage of older patients admitted via a regional ED. Method A clinical audit was conducted over a 2‐week period at a small regional hospital. Patients 65 years and over, taking 3 or more medications prior to admission, admitted via the ED and with a national inpatient medication chart (NIMC) prepared by a medical officer were identified. Eligible patients were provided with medication reconciliation by a pharmacist. Discrepancies between the medication history obtained by the pharmacist, the GP medication list and the NIMC were assessed. The clinical significance of the discrepancies were classified using a severity assessment code matrix. Results 48 patients were eligible and 75% had 1 or more discrepancy in their GP medication list. Almost half of the discrepancies were related to non‐current medications being recorded. Potential clinical significance of the discrepancies in 19% of patients was ‘moderate’ or ‘major‘. Conclusion While a GP medication list is a useful tool in the medication reconciliation process, it is not a complete representation of the patient's medications prior to admission.
Overlooking the ocean, near the town of Ōtsuchi, Japan, a white telephone booth containing a disconnected rotary phone sits within the Bell Gardia Kujira-Yama garden. Itaru Sasaki, its creator, named this booth kaze no denwa, or the wind phone. Sasaki built the wind phone in 2011 to "call" his cousin, who had recently died of cancer. He built the wind phone for personal use; however, after the March 11, 2011, earthquake/tsunami that claimed the lives of nearly twenty thousand people and left around twenty-five hundred missing, the wind phone unexpectedly became a destination for others mourning the loss of their loved ones. In the documentary The Phone of the Wind: Whispers to Lost Families, Sasaki elaborates on the naming of the phone booth: "The phone won't carry my voice. So I let the wind do it." 1 Over the years as people travel to use the phone, Sasaki has welcomed them to his garden, where they too can feel the wind transport their voices.As Sasaki's wind phone rose to popularity in Japan, 2 it also became popular in other parts of the world, inspiring films, novels, news articles, and other media. Many people journey from around the world to visit the wind phone, while others have built and continue to build their own versions. Each wind phone has different cultural contexts, geographic locations, and environments, but their purpose remains consistent: to give people a chance to speak to and feel heard by their departed loved ones. 3 This essay examines how the wind phone reinvents the communication technology of the telephone as a technology of mourning that helps the living feel heard by and connected to the dead. 4 Taking on multiple forms, the wind phone offers an interactive sensorial encounter that is not necessarily available through
Background: Continuity of medication management relies on accurate and complete medication information being communicated at transitions of care. Polypharmacy and older age are risk factors for medication-related events on discharge from hospital. Aim: To determine the type and number of discrepancies in the medication information included in electronic discharge summaries prepared for older patients discharged from the medical wards of a regional hospital when compared to the National Inpatient Medication Chart (NIMC) or discharge prescription used for medication supply. Method: Patients aged 65 years or older, taking three or more regular medications, and who were discharged from the medical wards with an NIMC or discharge prescription, and an electronic discharge summary, were identified, and discrepancies between the two sources of information recorded. A severity assessment code matrix was used to assess the potential clinical significance of the discrepancies. Results: Fifty patients were included in the audit. Sixty-eight percent (34) of the discharge summaries contained one or more discrepancies with a total of 107 discrepancies identified. Almost half (43%) of the discrepancies related to medications prescribed being omitted from the electronic discharge summary. Of the discrepancies, 29% were classified as having moderate potential clinical significance, and 50% as having minor clinical significance. Discussion: This audit demonstrated that the majority of electronic discharge summaries supplied by the hospital contained discrepancies. Improved communication between healthcare providers at transitions of care is needed in rural settings.
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