Thank you for the informative article by Carolyn M. Clancy, MD, entitled "Medication Reconciliation: Progress Realized, Challenges Ahead" (July/August, 2006). In addition to ensuring accuracy in a patient's drug type and making dosage available at key points in the healthcare continuum, medication reconciliation also reduces the risk of medication errors. The Institute for Safe Medication Practices (2005) indicated that the majority of medication errors are usually due to communication failure during the time of transition. Points of transition, as I understood Clancy, are said to be either at the time of admission, when the patient is transferred from one unit to another unit, or at the time of discharge. Clancy (2006) also concluded that 66% of errors occur at time of transfer to another unit, 22% at the time of admission, and 12% at the time of discharge. The article was very accurate with its findings and comparisons as well as informative by including such topics as the Joint Commission on Accreditation of Healthcare Organization (JCAHO) new safety goal and the challenges of coordination of information technology. The inclusion of the National Safety Goal requirements also helped me confirm what I had been hearing, but not sure was accurate. With the advent of the medication reconciliation form, there should be a notable difference and drop in mediation errors in the future. It is good to know that JCAHO will begin following up to visit facilities and look deep into the their processes regarding medication reconciliation.

I would like to advise you that the omission of putting some of the responsibility onto the patients themselves may do a disservice to the nursing or medial profession. We must all, in the healthcare environment, realize that in order for improvement to occur, both patient and provider need to communicate effectively and thoroughly.

Lisette M. Cintron, RN, BSN, CHCQM

Port St. Lucie, Florida