Through the Strengthening Medication Safety in Long-Term Care Project, ISMP Canada will be collaboratively developing metrics and measures that can enable Long-Term Care Homes, oversight organizations, and the Province to monitor the safety of medication management. These will include indicators relating to resident and family involvement in medication education and awareness, approaches to incident analysis, and three highly vulnerable processes in Long-Term Care: transitions of care, management of polypharmacy, and the management of high-alert medications.

These indicators and measures should be viewed alongside other resident safety and other medication safety or utilization reporting obligations. No indicator or group of indicators captures all possible information or performance status within a Long-Term Care Home. Rather, these candidate indicators should be viewed as instruments within the larger toolbox required to ensure safety and quality of life of both residents and staff.

The suite of indicators is anticipated in the Fall of 2021. If you have any comments or ideas about Long-Term Care medication management evaluation, please contact us at ltc@ismpcanada.ca.

Measurement and Evaluation Resources:

• Ontario Health Medication Safety Quality Standard
• The Measurement and Monitoring of Safety (Vincent) Framework
• Medication Safety in Polypharmacy: WHO Technical Report
• Medication Safety in High-risk Situations: WHO Technical Report
• Medication Safety in Transitions of Care: WHO Technical Report

Register

• Webinar: Getting Started with Medication Safety Self-Assessment for Long-Term Care (MSSA-LTC) [Slides]

The MSSA-LTC is designed to support the LTC sector to evaluate the safety of medication management systems by:

• Heightening awareness of the distinguishing characteristics of a safe medication system;
• Identifying vulnerabilities and opportunities for improvement related to medication system safety;
• Creating a baseline measurement of the current level of implementation of recommended strategies for medication safety; and,
• Monitoring progress over time through periodic repeated measurement.

Development and validation of the revised assessment content was supported by an expert Advisory Panel, which included residents and family representatives, an interdisciplinary group of health care providers with direct care and leadership responsibilities, and representatives from professional associations and regulatory authorities. The validation process included a pilot test, followed by cognitive interviews completed by the Accessing Centre for Expertise of the Institute of Health Policy, Management and Evaluation at the University of Toronto.

Topics and content for this revision have been derived from a variety of sources, including:

• Recommendations from the Gillese Report
• User feedback
• ISMP Canada and ISMP, United States, resources and learning from analysis
• A literature search conducted by the Canadian Agency for Drugs and Technologies in Health (CADTH) focused on best practices for medication management in LTC
• Content from the Medication Safety Self Assessment: Focus on "Never Events" in Long-Term Care.

For more information: email: mssa@ismpcanada.ca

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