UC Irvine

Background: Medication reconciliation represents a critical patient safety process in home health care, particularly for older adults managing polypharmacy and multiple chronic conditions. Hospital-to-home transitions increase the risk of medication discrepancies, adverse drug events, and rehospitalization. Implementation of a standardized medication reconciliation checklist may improve the consistency and completeness of Start of Care (SOC) visits in home health settings. Methods: This quality improvement (QI) project implemented a standardized medication reconciliation checklist over 8-weeks in a home health setting. Five registered nurses (5–25 years of experience) completed pre-and post-training surveys using a 5-point Likert scale. The checklist was utilized during eligible SOC visits for patients prescribed five or more medications. Process measures included checklist utilization and fidelity. Outcome measures included nurse-reported ease-of-use and confidence in identifying and resolving medication discrepancies. A mixed-methods evaluation used descriptive statistics to summarize checklist utilization and survey outcomes, with qualitative feedback obtained through survey comments and verbal nurse feedback. Results: Of 108 completed visits 107 were eligible for checklist use. The checklist was completed in 102 visits (95.3 %), with all submissions fully completed, indicating high fidelity. Utilization increased from 71% in week 1 to 100% by week 3 and was sustained throughout the project. Mean training scores improved from 2.93 to 3.88. Post-implementation surveys demonstrated a mean ease-of-use score of 3.97 and a mean confidence score of 4.8 (out of 5). Nurses reported improved organization and patient preparedness; however, an estimated 10–15-minute increase in visit time was noted. Conclusions: The standardized medication checklist demonstrated feasibility and acceptability in home health SOC visits, with high utilization rates, strong fidelity, and improved nurse-reported ease-of-use and confidence. Observed increased visit time may impact sustainability; workflow optimization is recommended for long-term implementation.