Table 1

Patient and institutional factors which make medication reconciliation more challenging

Patient demographicsInstitutional considerations
Nearly 25% non-English speakingAcademic public safety net hospital
Over 75% Medicare/Medi-CalMultisetting health network without a unified electronic health record, lacking a unified medication list
Over 15% homelessNo systematic approach to medication reconciliation
Median age 51 yearsLarge percentage of voluntary staff, large training programme