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34 To prevent these errors proactively, hospital pharmacists and pharmacy technicians should 21,33 conduct a thorough medication reconciliation at the time of admission, ensuring all home medications are accurately documented maintain clear, updated medication lists through each stage of hospitalization collaborate to ensure patients and caregivers receive comprehensive discharge counseling, with the technician reminding or prompting pharmacists if this step is missed, and reinforcing medication changes adherence instructions Lisas hospital has a structured transitions of care program

"So, the first thing that I always tell my patients to is to look at all local pharmacies

P., Zhou, C., Macpherson, L., Allen, S