Changes to the Assurance and Improvement in Medication Safety (AIMS) Program

In 2024, an evaluation found that engagement with the AIMS Program has remained consistently low, partly due to limited access to reporting by registered pharmacy staff. The evaluation also found that infrequent completion of the pharmacy safety self-assessment and an undefined frequency of continuous quality improvement (CQI) meetings have hindered the full integration of the AIMS Program in pharmacy practice. This level of engagement is not adequate for supporting the long-term sustainability and effectiveness of the College’s mandatory medication safety program.

The changes are informed by national best practices and alignment with NAPRA’s Model Standards of Practice for Continuous Quality Improvement (CQI) and Medication Incident Reporting (MIR) by Pharmacy Professionals, and are intended to improve engagement with the AIMS Program, strengthen patient safety, and support the development of a strong safety culture in community pharmacies.

The evolution of the AIMS Program, along with the addition and evolution of medication safety programs in other provinces, demonstrates the value placed on tracking and analyzing medication safety data in the public interest. It emphasizes the important role of pharmacies, regulators and other groups such as ISMP in collecting and sharing data across the country as a way to identify and prevent potential medication incidents from happening.

Engagement with the AIMS Program is important because it enhances patient safety and promotes a culture of safety and continuous quality improvement in community pharmacies. Medication errors are preventable, and active participation in the program helps pharmacies identify system gaps and implement targeted improvements to prevent recurrences.

Aggregate data recorded on the platform helps identify common medication errors, contributing factors, and high-risk medications. The more pharmacy professionals engage with the program, the better the data that can be shared back to pharmacies – leading to greater opportunities to improve patient safety and reduce risk of harm.

Allowing choice ensures the safety platform can integrate more smoothly with existing operations, reducing barriers to use by pharmacy staff. Giving pharmacies flexibility to select their own platform that meets their unique needs and workflows will ultimately improve participation and engagement.

In June, the Board made the decision to allow pharmacies autonomy to select their own medication incident reporting platform (provided it meets OCP’s criteria and contributes to NIDR). This decision was informed by the AIMS Program review which found low engagement with the program. Allowing pharmacies to choose a platform that best meets their unique workflows is intended to increase engagement with this important medication safety program. Ontario’s approach aligns with other provincial pharmacy regulators where pharmacies choose their own platform and pay the associated costs. Where it differs is that OCP will cover the cost of submitting the data to the NIDR to support a strong culture of medication and patient safety.

While updates to standards or policies require public consultation, decisions about the administration of College programs do not. Our Board’s decision is aligned with other provincial regulators that require pharmacies to choose their own platform and pay the associated costs. Where our approach differs is that OCP will cover the cost of submitting data to the NIDR to support a strong culture of medication and patient safety. 

The AIMS Program launched in 2019, and the NAPRA Model Standards of Practice for CQI and MIR were published in 2021 as other provincial regulators were considering or taking steps to implement similar programs in their jurisdictions. An evaluation of the AIMS Program in 2024 created an opportunity to propose several changes, including alignment with the NAPRA standards to reinforce AIMS principles. To date, four other provincial Colleges have either adopted or adapted NAPRA standards.

Sharing data at the national level helps to identify widespread risks and trends, enabling more effective coordinated interventions. It also supports consistency in safety practices, policy development, and shared learning across jurisdictions, ultimately improving patient safety across the country.

All data collected from Pharmapod remains valuable and will continue to be part of our broader medication safety efforts. We have preserved historical data at an aggregate level and provided guidance on how the data could be backed up at individual pharmacy sites prior to December 31, 2025.

A 60-day open consultation was held to gather feedback on the proposed changes to the AIMS supplemental Standard of Practice prior to approval at the December 2025 Board meeting. The Board decision to allow pharmacies autonomy to select their own medication incident reporting platform (provided it meets requirements and contributes to NIDR) as well as assigning responsibility for costs did not require consultation; however, information on this decision was included in the consultation materials posted.

The information presented to the Board is available in recent Board materials packages. The most recent discussions about AIMS took place in June, September and December 2025. The College will continue to share updates and resources with registrants on an ongoing basis using all its regular communication channels.

The changes – which include completing the safety self-assessment every two years and holding quarterly CQI meetings – align with national best practices and NAPRA model standards and are common in other provinces. They are intended to strengthen patient safety and support the development of a strong safety culture. Individual pharmacies still have the flexibility to determine how best to incorporate CQI program requirements into their workflows.

The safety self-assessment is an informative quality improvement tool that helps a pharmacy track their efforts to enhance patient safety over time. It can be used proactively to identify areas of potential risk, enabling pharmacy teams to plan improvement activities effectively and demonstrate system improvements. Requiring its completion every two years supports consistency and makes it easier for pharmacies to manage and meet deadlines. It also improves a pharmacy’s ability to maintain a safety culture by benchmarking data and tracking trends that can help identify and prevent medication incidents.

All registered pharmacy staff require unique logins at their primary place of practice. Occasional staff, such as relief pharmacists, would not be required to have individual logins.

To fulfill the requirements of the AIMS Program, pharmacies must have access to an incident management platform that supports continuous quality improvement. It must meet all of the requirements set out by the College here.

Yes. Pharmacies are still expected to meet the requirements of the AIMS Program during the 2026 transition of the program, including recording, documenting, analyzing, and sharing learnings about the incident.

If a pharmacy has not yet made a decision on which medication incident reporting platform they will use, then it must record medication incidents locally until such time that it has begun to use a chosen platform that meets program requirements. A template form will be made available on the OCP website as an option for pharmacies to record medication incidents.

Pharmacies that have decided to choose a new platform should review medication incident reporting solutions that meet the College’s criteria and sign up with the platform of their choice by January 1, 2027.