Medication reconciliation is an important patient safety initiative. The goal of this QI project is to improve both the rate of completion as well as the quality of the medication reconciliation for paediatric patients admitted to a surgical ward in a tertiary care teaching hospital. Throughout this project we learned that having key stakeholders involved from the beginning of the project is imperative to the success of the work. We made the assumption that medication reconciliation starts at the time the patient is admitted to the ward, but we learned that in reality, surgical patients begin their journey in the pre-operative area where the initial medication history is started. Another important lesson we learned is assessing the sustainability of change ideas prior to implementing them.