Medication Safety Self-Assessment for Paramedic Organizations Introduction

This Medication Safety Self-Assessment® for Paramedic Organizations (MSSA-Paramedic Organizations) is designed to support evaluation of the safety of medication management processes in the pre-hospital and paramedicine environment 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 completed by a core working group and supported by a multi-level expert Advisory Panel.

Topics and content for this assessment have been informed through a variety of sources, including:

  • A literature search conducted by the Regional Paramedic Program of Eastern Ontario (RPPEO)
  • ISMP Canada resources and learning from analysis (e.g., safety bulletins, MSSA programs)
  • Advice of the core working group and expert Advisory Panel


The MSSA-Paramedic Organizations is a novel assessment program that was developed collaboratively by the Regional Paramedic Program for Eastern Ontario (RPPEO) and the Institute for Safe Medication Practices Canada (ISMP Canada). This MSSA program aims to enhance and improve the safety of local processes related to medication management in the broader Canadian paramedicine environment.

The RPPEO and ISMP Canada are not standard-setting organizations and the assessment items in this document are not intended to represent a minimum standard of practice. Some of the practices described in the items represent innovative practices and system enhancements that are not yet widely implemented in the paramedicine environment; however, their value in reducing errors is grounded in research and expert analysis of medication incidents occurring in paramedicine and other health care sectors.

Individual paramedic organizations should not expect to score highly in all areas. The process of completing the MSSA-Paramedic Organizations is intended to identify areas of focus for quality improvement and enhancement of safe medication practices. MSSA results can be combined with learning from review of incident reports to support continuous quality improvement. MSSA findings are intended for internal use and become more useful as repeat assessments are performed to see where improvements have been achieved over time and where challenges remain. MSSA findings are also useful for de-identified analysis and learning at a system level.

Structure of the MSSA

The MSSA-Paramedic Organizations includes 120 assessment items divided into 9 sections. A complementary MSSA for Practicing Paramedics is also available.

The high-level topics are referred to as “Key Elements”. Each Key Element section is divided into one or more sub-sections, referred to as “Core Characteristics”. Each Core Characteristic section includes a number of assessment items. Teams are asked to rank the current level of implementation for each assessment item.

Privacy and Confidentiality

The web-based survey tool will immediately download the information into a secure database maintained solely by ISMP Canada. ISMP Canada is committed to protecting the privacy, confidentiality, and security of any information for which it is responsible. All activities related to MSSA data are conducted in compliance with ISMP Canada's privacy policy.

Participating paramedic organizations are able to access aggregate results for comparative purposes. Individual responding organizations cannot be identified from the aggregate results.

Aggregate data will be used by ISMP Canada for quality improvement, research and education purposes.