Transfer is a vulnerable setting that increases the risk of medication errors. Medication reconciliation (MedRec) ensures accurate medication transfer at interfaces of care. It is addressed as a key performance indicator (KPI) in a tertiary hospital. The issue was failure to meet the KPI of more than 75%; the objective was to improve compliance with transfer MedRec. A quality improvement project was conducted utilizing physician active education, leadership support, and the Irish Health Service Executive (HSE) change model. Compliance with the KPI did not improve with monthly monitoring and physician education. Following leadership support, compliance increased from 56% to 72% but was not sustained. Adoption of the change model yielded a sustainable improvement from 65% to 81% within 1 year of the intervention and a reduction in medication errors. Improvement in the MedRec process requires a culture of accountability to change. HSE expedited stakeholders’ engagement and implementation of the planned interventions.
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