To advance the patient safety agenda, in August 2011 the Ontario Ministry of Health and Long-Term Care issued a directive that hospitals must report critical incidents involving medications and intravenous fluids to the Canadian Institute for Health Information National System for Incident Reporting (NSIR). A critical incident is an "unintended event that occurs when a patient receives treatment in the hospital that results in death, or serious disability, injury or harm, and does not result primarily from the patient's underlying medical condition or from a known risk inherent in providing treatment".
ISMP Canada has been identified as the lead organization for analysis of the reported incidents. A multidisciplinary team reviews each submitted critical incident report to ensure effective identification of the contributing factors. In addition, ISMP Canada will periodically conduct aggregate analysis of reported incidents to provide a more in-depth assessment of events involving a particular medication or care setting. On the basis of these analyses, ISMP Canada will develop and disseminate outcome-directed recommendations, with an emphasis on high-leverage actions that take into account human factors engineering principles and the need to design systems with integrated safeguards.
Collaboration with the Ontario Drug Policy Research Network (ODPRN)
ISMP Canada is collaborating with the Ontario Drug Policy Research Network (ODPRN) to disseminate medication safety-related studies. The ODPRN is a province-wide network of researchers who provide timely, high quality, drug policy relevant research to decision makers. The following ODPRN research minute publications provide summaries of selected medication safety-related studies.