The Assurance and Improvement in Medication Safety (AIMS) Program is a mandatory medication safety program for community pharmacies in Ontario. It supports continuous quality improvement on the premise that identifying mistakes and learning from them fosters a safety culture and reduces risk of harm to patients. As part of the program, pharmacies are expected to record medication events — incidents and “good catches” — into a third-party platform. By recording this information, pharmacies can identify how and when errors are occurring and how best to prevent them. This knowledge can inform changes to their environment and processes.
Data are self-reported and individual pharmacies only have access to the details related to their own medication events; the third-party platform collects this information and shares aggregate and de-identified data with the College. The College then collaborates with health system partners with data analytics expertise to glean insights from the anonymous data. The anonymity of the program is crucial to creating a safety culture where individuals are comfortable bringing forward medication incidents without fear of punitive outcomes.
The College is committed sharing the data made available to them in a way that can assist with quality improvement initiatives. Since the inception of the program, the College has shared data related to the following event recording fields available through the AIMS Program:
- Number of events
- Number of pharmacies recording
- Harm level
- Events by what happened
- Events by why it happened
- Events by medication system stage
Details about the individual fields are outlined below. It is important to note the College does not independently verify or validate the data in any way, nor does that College have access to any detailed information related to specific incidents reported through the platform. The College transparently shares back data with pharmacies with the goal of highlighting trends and patterns and making practice recommendations to reduce risks, and with the view that learning from medication events makes pharmacies safer.
About the Data
The College only has access to de-identified, aggregate AIMS data for the purposes of reviewing medication event trends and supporting shared learning and system-based improvements across the province. The College does not validate or independently verify information reported through the program, nor does it have access to details connecting reported events to individual pharmacy professionals or pharmacies. Anonymous reporting is crucial to creating a safety culture.
Events Recorded
Medication incidents are any preventable event that may cause or lead to inappropriate medication use or patient harm. Medication incidents may be related to professional practice, drug products, procedures, or systems, and include prescribing, order communication, product labelling/packaging/nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use.
Good catches (previously “near misses”) are any event that could have led to inappropriate medication use or patient harm but did not reach the patient. Good catches provide valuable insight into areas of risk and may indicate where systems can be improved to prevent harm. More information on when to record good catches can be found in this Pharmacy Connection article.
Number of Pharmacies Recording
Number of pharmacies recording shows the number of pharmacies that recorded at least one event during the year. Pharmacies that have recorded more than one event will only be counted once. For context, there are approximately 4,600 community pharmacies in Ontario.
Events by Medication System Stage
Events by medication system stage shows the step in the process, such as order entry, prescribing or patient education, during which the event took place.
Events By What Happened
Events by what happened shows the numbers of each event type, such as incorrect drug, incorrect label or duplication of therapy, that have been recorded.
Events by Why It Happened
Events by why it happened show the contributing factors, such as environmental, staffing or workflow problems, critical patient information missing or lack of quality control or independent check systems, that were involved in an event. During event recording, more than one contributing factor can be selected. This means that the totals for contributing factors may be more than the total number of events recorded.
Incidents by Harm Level
The Institute for Safe Medication Practices defines harm as a temporary or permanent impairment in body functions or structures. This includes mental, physical, sensory functions and pain. Incidents by harm level shows the number of incidents by harm level category. Harm levels are recorded based on the recording individual’s interpretation of the event. The harm category classifications are as follows:
- Unknown – It is not clear the degree of harm caused to the patient.
- None – Patient is not symptomatic or no symptoms are detected and no treatment or intervention is required.
- Mild Harm – Patient has mild, temporary and short-term symptoms. No treatment, extra observation or mild medical treatment or intervention is required.
- Moderate Harm – Patient required additional treatment or intervention, hospitalization, or the incident resulted in minor permanent harm or loss of function.
- Severe Harm – Patient is symptomatic and required treatment or major surgical/medical to save the patient’s life. The incident is responsible for loss of function, shortened life expectancy or major permanent long-term harm.
- Death – The incident may have caused or contributed to the patient’s death.
Data Reports
Data are made available in a report format that will include recommendations based on the observed trends.
- See the 2023 AIMS Data Report
- See the 2024 AIMS Data Report (forthcoming)
Continuous Quality Improvement
This AIMS data should be used for continuous quality improvement to reduce the risk of medication incidents. Registrants are encouraged to data to inform quality improvement work, along with other resources to support medication safety. These include:
- AIMS platform: Continuous quality improvement tools are available within the AIMS Pharmapod platform
- AIMS Program e-Learning: Mandatory e-learning modules are available from the AIMS Pharmapod platform or College website, including a continuous quality improvement module
- Taking AIMS: the AIMS Response Team Bulletin for the Pharmacy Profession in Ontario (September 2019): A preliminary independent analysis of medication incidents and good catches recorded on the AIMS platform
- ISMP Canada Safety Bulletins: Analysis of ISMP medication incident data and recommendations to improve safety