Medication Safety Self-Assessment for Community Pharmacy - Comprehensive Canadian Version II Introduction

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The Institute for Safe Medication Practices Canada (ISMP Canada) is pleased to provide an updated version of the Medication Safety Self-Assessment (MSSA) for Community Pharmacy.

The goal of this assessment is to help community pharmacy teams to identify and address vulnerabilities that could lead to medication incidents and patient harm. The MSSA for Community Pharmacy includes focused content related to high-risk processes, use of high-alert medications and treatment of vulnerable populations, also published separately in the MSSA: Focus on Never Events in Community Pharmacy

This program is designed to support community pharmacy teams in:

• Raising awareness of the characteristics of a safe medication system in the community pharmacy setting;
• Identifying vulnerabilities in medication management processes to support development of quality improvement plans;
• Creating a baseline measurement for the current implementation of recommended strategies to avoid harm events; and
• Evaluating progress over time.

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

• Published literature related to safe medication practices in pharmacy practice
• ISMP Canada resources and learning from analysis (e.g., reports to the National Incident Data Repository for Community Pharmacy, Safety Bulletins, other MSSA programs, including the MSSA: Focus on Never Events in Community Pharmacy, recommendations from community pharmacy on-site assessments)
• ISMP (United States) resources (e.g., newsletters, MSSA programs)
• CPSI resources (e.g., Global Patient Safety Alerts)
• National Association of Pharmacy Regulatory Authority (NAPRA) model standards of practice for pharmacists and pharmacy technicians

Development and validation of the assessment content was supported by an expert Advisory Panel which included or represented patient and family advisors, practicing pharmacists and pharmacy technicians, pharmacy regulatory authorities, academic institutions, a national pharmacy association and a prescriber. A modified Delphi survey was conducted to add rigor to the content selected for inclusion; participants in this process included community pharmacy experts in addition to the Advisory Panel.

The MSSA for Community Pharmacy assessment includes a total of 116 items, divided into 7 sections. The high-level topic sections are referred to as "Key Elements" and the corresponding sub-sections are called "Core Characteristics". Sections I to IV focus on general strategies for safety. The categories in these 4 sections are derived from an analysis of recommendations from on-site visits to 30 community pharmacies conducted by ISMP Canada over a 5-year period. Other sections focus on selected clinical situations and considerations for high-alert medications. Not all items will be applicable in all settings.

This self-assessment supports continuous quality improvement initiatives in community pharmacies. The value of ongoing evaluation with a self-assessment program was highlighted in a 12-year review of responses to ISMP Canada's MSSA for Long-term Care, which showed that mean total self-assessment scores improved over time.

ISMP Canada is not a standard-setting organization and the assessment items in this document are not intended to represent a minimum standard of practice.

The MSSA for Community Pharmacy and its components are copyrighted by ISMP Canada. The assessment is intended for use as part of ongoing quality improvement activities. Other uses, such as in education presentations external to an individual pharmacy or corporate group require written permission from ISMP Canada.