- Initiative Overview
- High-Alert Medications
- Incident Analysis
- Independent Double Check
- Insulin Destruction and Disposal Practice Tool
- Just Culture
- Measuring and Evaluating
- Medication Management Model Policies
- Medication Reconciliation
- Med Safety Signal
- Quality Improvement
- Resident and Family Engagement
- Safer Transitions in Care
Initiative Launch and Update Webinars
The Strengthening Medication Safety in Long-Term Care initiative was publicly launched by ISMP Canada on June 25, 2021. View the webinar recording and PPT slides for an overview of the initiative and the activities that will be implemented.YouTube Video
A Provincial Update Webinar was held on December 15, 2021. View the webinar recording and PPT slides to learn about the selection of Champion Homes and the 5 foundational aspects of the initiative!YouTube Video
A Provincial Update Webinar was held on March 23, 2022. View the webinar recording and PPT slides to learn about the how the Champion Homes have completed their Baseline Medication Safety Assessment and started to use the Incident Analysis for LTC tools in practice.YouTube Video
A Provincial Update Webinar was held on June 22, 2022. View the webinar recording and PPT slides to learn about how the Champion Homes used the Resident and Family Engagement Survey to improve engagement in their medication management processes, used process mapping to document the Medication Reconciliation process and collected data on distractions during the Med Pass to improve medication administration.YouTube Video
A Provincial Update Webinar was held on September 20, 2022. View the webinar recording and PPT slides to learn about the next phase of the initiative where we will be inviting up to 100 Trailblazer homes to take part in one of the initiative streams
- resident and family engagement,
- reporting, learning, and acting when an incident occurs,
- adapting and implementing a model policy,
- improving the medication reconciliation process, and
- initiating a quality improvement project.
In addition, three Champion Homes share their learnings on the use of the incident analysis tools, the introduction of an automated dispensing cabinet for emergency supply medications and the adaptation of one of the model policies.YouTube Video
A Provincial Update Webinar was held on December 7, 2022. View the webinar recording and PPT slides to learn about the launch of the Trailblazer Homes Champion Homes on November 3, 2022 as well as Champion Home updates on their medication safety projects involving Orientation and Training for Medication Administration and Order Processing and Reducing Distractions during the morning medication pass.YouTube Video
A Provincial Update Webinar was held on March 22, 2023. View the webinar recording, PPT slides, and related resources to learn how 5 homes in Ontario are spreading and scaling the initiative!YouTube Video
Niagara Region Resident and Family Engagement ResourcesSeniors’ Medication Script
Medication Script for the Lanyard
IAPS Spectrum template
A webinar in celebration of the Strengthening Medication Safety in Ontario Long-Term Care initiative was held on June 14, 2023. View the webinar recording and PPT slides to learn about quality improvement projects completed by Champion Homes, and improvement stories from Trailblazer Homes participating in the initiative. In addition, members of four Trailblazer Homes share their experiences related to improving medication safety through a panel discussion.YouTube Video
High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error. Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly more devastating to patients.*
- chemotherapeutic agents
- parenteral nutrition preparations
- Standardizing the ordering, storage, preparation, and administration of these products
- Improving access to information about these drugs
- Limiting access to high-alert medications
- Using auxiliary labels and automated alerts
- Employing redundancies
Independent Double Check for Long-term Care eLearning Module
This eLearning module describes the elements of a good Independent Double Check for high-alert medications that are administered to residents in Long-term Care. Through the use of animated videos, learners will be able to see different examples of independent double checks being performed correctly, as well as some common reasons why they are performed incorrectly.
For more information on identifying and reducing the risks associated with high-alert medications, contact us at LTC@ismpcanada.ca
*Institute for Safe Medication Practices. Available at: https://www.ismp.org/recommendations/high-alert-medications-long-term-care-list
To effectively improve medication safety in a long-term care home, it is important to recognize and understand what medication incidents are occurring, why, and what evidence-based actions should be taken to reduce the risk of the same incident occurring again.Incident Analysis
Independent Double Check for Long-term Care
This eLearning module describes the elements of a good Independent Double Check for high-alert medications that are administered to residents in Long-term Care. Through the use of animated videos, learners will be able to see different examples of independent double checks being performed correctly, as well as some common reasons why they are performed incorrectly.Register
Insulin Destruction and Disposal Practice Tool
To guide the proper destruction and disposal of insulin in the long-term care setting improving accountability.Insulin Destruction and Disposal Practice Tool
To ensure that medication incidents are reported, learn about how to support a Just Culture in long-term care.Just Culture
Measuring and Evaluating
Through the Strengthening Medication Safety in Long-Term Care Project, ISMP Canada will be collaboratively developing metrics and measures that can enable Long-Term Care Homes, oversight organizations, and the Province to monitor the safety of medication management.Measuring and Evaluating
Medication Management Model Policies
ISMP Canada is pleased to provide the following Model Policies for testing and feedback to LTC Homes in Ontario.Feedback - Model Policies
- Model Policy 1 for Testing: Medication Reconciliation (MedRec)
- Model Policy 2 for Testing: High-Alert Medications
- Model Policy 3 for Testing: Monitoring for Preventable Harm from Medications
- Model Policy 4 for Testing: Quarterly Medication Assessments
- Model Policy 5 for Testing: Emergency Medication Supply
- Model Policy 6 for Testing: Drug Destruction and Disposal
- Model Policy 7 for Testing: Automated Dispensing Cabinets
- Model Policy 8 for Testing: Medication Storage
- Model Policy 9 for Testing: Incident Reporting and Analysis
Medication reconciliation (MedRec) is a component of medication safety that can reduce communication and medication errors that have the potential to cause harm at transitions of care to long-term care.
We have developed tools to support MedRec in long-term care, starting with tools to support a systematic process to obtain and document the best possible medication history (BPMH).
- Medication Safety at Transitions of Care for Long Term Care Providers eLearning Module
This module will provide an introduction to medication safety at transitions of care for long term care providers. It will also provide techniques, tips and tools to obtain the best possible medication history (BPMH) using a systematic process. This practical approach will teach clinicians how to engage residents and caregivers in a dialogue about their medications and help them to learn how to do medication reconciliation (MedRec) by identifying and resolving medication related discrepancies.This module is part of the 3-year initiative funded by the Ontario Ministry of Long-Term Care which enables the module to be without cost to those accessing.
- Components of Medication Management Infographic
This infographic describes the components of medication management and how they inter-relate. It begins with an accurate and reliable Best Possible Medication History, the fundamental cornerstone of MedRec.
- How to obtain a BPMH in Long-Term Care
This resource provides the information to help providers choose the best sources of information to use and provides a step-by-step guide to obtain a BPMH.
- BPMH Self-Evaluation Checklist
This BPMH self-evaluation checklist can help to ensure that a systematic process has been used to obtain a BPMH from a resident or their substitute decision maker.
- BPMH Documentation Tips for LTC
Tips for documenting the BPMH for practitioners in LTC.
- Top Ten Practical Tips BPMH in Long-Term Care
Top ten tips to obtain the BPMH for practitioners in LTC.
- Medication Reconciliation (MedRec) in Long-Term Care Version 3 Getting Started Kit
This kit provides guidance to implement medication reconciliation in Long-Term Care.
- Paper to Electronic MedRec Implementation Toolkit
As Homes move from paper towards electronic MedRec tools, this toolkit provides ideas, considerations and best practices for selection and implementation of an electronic MedRec system.
MedRec Quality Audit Data Collection Tools
These tools were designed for use in Long-Term Care and were developed to allow organizations to assess the quality of their medication reconciliation (MedRec) practices and determine the areas requiring process improvement(s).
- Instructions for LTC MedRec Quality Baseline Audit
- LTC MedRec Quality Audit Data Collection Form
- LTC MedRec Quality Baseline Audit Tool
How to do a BPMH for a Re-admission to Long Term-Care
This video describes the process of completing a BPMH for a re-admission to long-term care. A case example is used to illustrate this process.
- Medication Safety at Transitions of Care for Long Term Care Providers eLearning Module
Med Safety Signal
- Med Safety Signal: Vaccine Error
- Med Safety Signal: A Patchy Approach to Transdermal Fentanyl Safety
- Med Safety Signal: Vulnerabilities in Quarterly Medication Review Process
- Med Safety Signal: Hydromorphone dosing confusion
- Med Safety Signal: Problems with Conditional Medication Orders
- Med Safety Signal: Missed Methotrexate
- Med Safety Signal: Quantitative Analysis of Medication Errors in Ontario Long-Term Care Homes
The Med Safety Signal is a fantastic reference tool for home use. It holds invaluable information that can assist homes to reflect on their practices and see areas of improvement. Any improvements made benefit the safety of the residents! I would highly recommend anyone working in long term care subscribe to the med safety signals!
Deprescribing and Safe Medication Use in Long-Term Care For Health Care Providers Resource
This resource provides the information to help health care providers understand the importance of deprescribing and provide deprescribing resources and tools.Deprescribing Resource
Within Long-Term Care homes, Quality Improvement is a journey of residents and families, personal support workers, nurses, physicians, managers, and pharmacists coming together, staying together and working together towards improved outcomes.
During the “Strengthening Medication Safety in Long-Term Care” initiative, ISMP Canada provides support in two areas of Quality Improvement:
- Education and Training in Quality Improvement Techniques
- Coaching and Facilitation of Quality Improvement Teams
Resident and Family Engagement
Residents in Ontario’s long-term care are the heart of every home. They have reached a stage in their life where they need to rely on others to support and to care for them, and while there are some residents who cannot be autonomous in their own care, there are many who are able to self-advocate and make decisions for themselves in their medication management. Engaging residents is essential to increasing medication safety and this initiative aims to support you, with resources and education, to do so authentically. Collaboration between staff and residents gives the best possible chance for safe medication experiences.Resident and Family Engagement
Safer Transitions in Care