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Medication Safety Self-Assessment® for Community/Ambulatory Pharmacy™


Instructions for Conducting the Self-Assessment

1. Ideally, you will assemble a team from among your pharmacy staff to complete the self-assessment. These people will be given the responsibility to evaluate, accurately and honestly, the current status of medication practices in your pharmacy. Because medication use and dispensing are complex processes that involve more than one person, the value and accuracy of the self-assessment will be enhanced if it is completed by a number of members of the pharmacy team.
The estimated time to complete the self-assessment is about three hours. We recommend three team meetings of one hour each.

2. Before the self-assessment begins, have the team members read the survey in its entirety. If possible, send copies of the survey to the team members for review before the first team meeting.

3. Complete the "Demographic Information".

4. Review each core distinguishing characteristic and evaluate the pharmacy's current level of implementation of the self-assessment items. As necessary, investigate and verify with other staff in the pharmacy the level of implementation for each item.

When a decision is made about the level of implementation for each self-assessment item, mark one of the following choices next to each item:

A = There has been no activity to implement this item

B =
This item has been discussed for possible implementation in the pharmacy but has not been implemented at this time

C =
This item has been partially implemented for some or all patients, prescriptions, drugs or staff

D =
This item is fully implemented for some patients, prescriptions, drugs, or staff

E = This item is fully implemented for all patients, prescriptions, drugs, and staff

For self-assessment items with multiple components, full implementation (a score of "D" or "E") is appropriate only if all components are present. If only one or some of the components have been partially or fully implemented, the self-assessment scores should not exceed "C".

For self-assessment items with two distinct elements, each separated with the word "OR," and labeled (a) and (b), answer either part (a) or (b) but not both.

Once all of the self-assessment items have been completed, and the level of implementation determined, enter your ratings through this ISMP Canada secure web site. The special, web-based tool will immediately download the information into a database maintained solely by ISMP Canada. No data will be maintained on the Internet form after it has been submitted. Confidentiality is assured.

To enter your data, a password is required. You can obtain a password by sending an email request to

Although it is possible to enter and save your results by section, all data should preferably be entered at one time, as this will reduce the opportunity for entry errors.

The database will produce weighted scores from your responses. You can then view your results and print them in tabular or graphic form. This allows for a snapshot view of your current status, as well as comparison with aggregate data, when available. You can also compare your own results to monitor your improvement over time. No other user of the MSSA is able to access or view your results.