Date of Completion

Summer 2026

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Melanie Brewer

Second Advisor

Dr. Brandee Temmis

Abstract

Background: Clinician compliance with medication reconciliation at a home health agency was below regulatory expectations, with agency performance significantly lower than state and national averages. Workflow inefficiencies, inconsistent clinician practices, and limited training contributed to noncompliance, increasing the risk of medication discrepancies, preventable rehospitalizations, and Medicare reimbursement penalties.

Aim: This quality improvement project implemented a standardized medication reconciliation workflow using the Agency for Healthcare Research and Quality’s MATCH toolkit to improve clinician compliance during admission to home health.

Evidence: Literature supports structured medication reconciliation as an effective strategy to improve safety during transitions of care. The MATCH toolkit provides a stepwise process for obtaining accurate medication histories and improving patient understanding of medication regimens.

Design: Implementation was guided by the OhioHealth Change Management Model and iterative Plan-Do-Study-Act cycles. Readiness assessment, stakeholder engagement, and phased adoption supported the sustainable integration of a new workflow.

Intervention: The intervention included a MATCH-based workflow, electronic health record discrepancy-reporting fields, a document-upload process for reconciled medication lists, targeted clinician education, supervisory reinforcement, and 48-hour follow-up calls.

Outcomes: Medication reconciliation was completed at admission for 98% of patients. Completion of 48-hour follow-up calls reached 92.2%, and 98% of patients or caregivers reported receiving medication teaching.

Implications for Nursing: Standardized medication reconciliation reduced practice variation, strengthened communication during transitions of care, improved regulatory alignment, and supported safer, more patient-centered home health care.

Rights

Copyright, all rights reserved

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