“Whose job is it, really?” physicians', nurses', and pharmacists' perspectives on completing inpatient medication reconciliation

Medication reconciliation, when performed well, effectively identifies discrepancies and reduces medication errors in the hospital setting.1–3 This process involves four major steps: 1) obtain and document a comprehensive medication history on admission, 2) compare the medication history to medication orders in the hospital and identify and resolve discrepancies, 3) provide the patient with a written list of discharge medications, and 4) educate the patient about their discharge medication regimen.4–6