Grant Application

Zachary Marcum, PharmD, MS, in partnership with Neil Resnick, MD, and Anne Kisak, MBA, MSN, CRNP, of Magee-Womens Hospital of UPMC

Proposed Innovation

Older patients are often confused and frustrated with medication instructions following hospital discharge, putting them at high risk of potentially dangerous medication discrepancies, or errors.

To address this mounting problem, this project followed older patients within seven days of hospital discharge from Magee-Womens Hospital of UPMC to identify the root causes of common medication discrepancies. Investigators used shared decision making to engage patients and caregivers and improve understanding of the medication information they need — and want — when leaving the hospital.


The team developed a screening tool to identify patients at high risk for medical discrepancies after discharge. The team also revised medication education material given to patients on discharge to make them more “patient-centered.”


The project helped to improve understanding of medications and empower patients and their caregivers as informed care partners — resulting in reduced medication discrepancies and improved care. In addition, equipping clinicians with a risk-screening tool further reduces discrepancies and improve care. The end result: improved quality of care and quality of life for older adults, reduced caregiver stress regarding medications, and reduced readmissions.