creating a standardized medication list by interviewing patient and/ or relatives according to Best Possible Medication History (BPMH) after patient transfer to medical ward

number of unintended medication discrepancies comparing medication history taken when admitted to emergency department and BPMH after transfer to medical ward

expert panel classifies each unintended medication discrepancy in 1 of 3 classes for its potential to cause patient harm. Class 1 discrepancies are those unlikely to cause patient discomfort or clinical deterioration. Class 2 discrepancies could potentially result in moderate discomfort or clinical deterioration. Class 3 discrepancies could potentially result in severe discomfort or clinical deterioration.