With the recent addition of med reconciliation in the ISMP targeted best practices for hospitals specifically the recommendation of "Obtain most accurate medication list possible upon admission to organization before first dose of medication is administered"...

At our hospital we have a pre-defined list of criteria that identifies pts as high risk for pharmacy to interview and do a thorough medication history and document their PTA med list. However sometimes physicians perform order reconciliation prior to pharmacy doing a med history interview and orders are placed (from a non-updated home med list in EMR) and doses are given before pharmacy is able to intervene.

How are other hospitals meeting this new recommendation from ISMP? Are physicians waiting to be notified by pharmacy when they are done with updating the home med list before starting order reconciliation? If so, what is the turn-around time in which pharmacy is able to perform med history for a pt once identified as high risk?