3% of patients (95% CI = 43.5 – 83.7%) (19 medications) with at least one moderately severe discrepancy and 45.5% of patients (95% CI = 24.6 – 66.3%) (10 medications) with a minor discrepancy. The results shows that discrepancies occur between the hospital discharge prescription and the patient’s further supply of medication as reported by the parent. The results indicate that 36.8% of patients experienced discrepancies post hospital discharge which is higher HDAC inhibitor than the 14.1% of post discharge discrepancies experienced in older adults aged 65 from an adult study[2]. The results indicate that 7.6% of

patients (95% CI = 1.1% – 16.0%) who are discharged will experience an unintended moderately severe medication discrepancy post discharge. 1. Dean BD, Barber N. A validated reliable method of scoring the severity of medication

errors. click here American Journal of Health-System Pharmacists. 1999; 56: 57–62. 2. Coleman EA, Smith JD, Raha D, Min S-J. Post hospital medication discrepancies. Prevalence and contributing factors. Archives of internal medicine. 2005; 165: 1842–1847. Rowan Yemm1, Debi Bhattacharya1, David Wright1, Anne Regan2, David Green2, Lorna Hollister2 1University of East Anglia, Norwich, Norfolk, UK, 2Colchester Hospital University NHS Foundation Trust, Colchester, Essex, UK In recent guidance, RPS emphasises the importance of communicating medication changes at discharge Charts were amended to allow better annotation of changes, which it was hoped would translate onto Electronic Discharge summaries (EDS) Whilst changes on charts increased from 51.7% to 62.8%, no improvement was seen on EDS or the general practitioner’s (GP) list after discharge More work is needed to establish how, if not from charts, doctors source information for preparing EDS. In 2011, RPS published guidance to support the transfer of care1, which emphasises the importance of communicating changes in medication across the interface. Colchester hospital volunteered as an early adopter, participating in a 6-month programme to assess the effect of amending inpatient medication charts PIK3C2G to include additional fields for annotating medication changes. This

study aimed to investigate the effect of these amendments on the annotation of new medicines, dose changes and discontinuations on charts, and whether this improves the quality of information provided on EDS, and GP-held information after discharge. Data were collected over 7-day periods in November 2011 (pre implementation), March and May (2 & 4 months post implementation) from 2 medical wards purposively selected for high patient turnover. Charts and EDS for patients discharged from study wards during data collection were reviewed. Researchers identified where medication changes had occurred, and whether these were annotated in new chart fields and explicitly stated on EDS. Fisher’s exact test was used to compare proportions. Short-term changes (e.g.