Assessing the State of Safe Medication Practices Using the ISMP Medication Safety Self Assessment (R) for Hospitals: 2000 and 2011

Background: Since development of the Institute for Safe Medication Practices (ISMP) Medication Safety Self Assessment (R) for Hospitals in 2000, hospitals have used the tool to assess medication safety practices and identify opportunities for improvement. The Assessment was updated in 2011 to create a new baseline of hospital medication safety efforts and determine if progress has been achieved in the interim. Methods: Hospitals in the United States were asked to voluntarily complete the 2011 Assessment and submit their data confidentially to ISMP from April to October 2011. The Assessment contained 270 items organized into 10 key elements and then further divided into 20 core characteristics. Results: By October 2011, 1,310 hospitals had submitted data to ISMP for a response rate of 23% for all 5,786 hospitals. Scores in 2011 increased significantly from 2000. The largest percent improvements were in core characteristics related to communication of drug orders, patient education, and quality processes and risk management. Hospitals in 2011 scored lowest in areas related to patient information, staff competency and education, and drug information. Higher scores for the core characteristics related to the organizational culture and staff education about medication error prevention were associated with higher scores for the core characteristic associated with error detection, reporting, and analysis. Hospitals with a medication safety officer scored higher in all key elements than hospitals without. Conclusions: While substantial medication safety improvements have been achieved within the last decade, opportunities still exist to improve medication safety. Widespread adoption of key safety strategies will be more effective if influential groups work together and external forces provide the necessary pressure via regulations, standards, public policy, or incentives.