When should medication reconciliation be performed?

• A. At discharge only
• B. At admission only
• C. Only when new medications are prescribed
• D. At admission, status changes, during transfers, and discharge

Answer: (D)

Medication reconciliation is a safety process that ensures the list of medications a patient should be taking is complete and accurate as they move through different points of care. It is not a one-time check but a ongoing verification at key transition moments to prevent omissions, duplications, dosing errors, or dangerous interactions.

The best approach is to perform reconciliation at admission, whenever the patient’s status changes, during transfers between units or facilities, and at discharge. These moments are when medication regimens are most likely to change or become unclear, so reconciling the meds then helps ensure the right drugs, dosages, and instructions are continued or appropriately adjusted.

Why the other options aren’t sufficient: doing it only at discharge misses changes that occur during the hospital stay; doing it only at admission misses updates that happen later, such as after procedures or during transfers; and doing it only when new meds are prescribed ignores existing prescriptions and any ongoing therapies that the patient should be taking. Reconciliation across all these transition points provides the safest and most accurate medication information for the patient and the next care team.