The effect of a medication reconciliation program in two intensive care units in the Netherlands: a prospective intervention study with a before and after design

Study procedure pre- and post-intervention. BPMDL-ICU best possible ICU medication discharge list, BPMH best possible medication history, BPML-GW24 best possible general ward medication list 24 h after ICU discharge, CPOE/CDS system computerized physician order entry systems with clinical decision support, ER emergency room, HIS hospital information system, ICU intensive care unit, OT operating theater, PDMS patient data monitoring system, TIM Transfer ICU and Medication reconciliation progra