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AIMS Data & Resources

The overall goal of the AIMS (Assurance and Improvement in Medication Safety) program is to improve medication safety through the recording and analyzing of incidents and near misses to help identify solutions aimed at preventing them from recurring. The College is committed to supporting community pharmacies to use data to strive towards this goal and emphasizing learning through a safety culture where individuals are comfortable bringing forward medication incidents without fear of punitive outcomes.

The College is moving towards using data differently, including making data available in a way that can assist with quality improvement initiatives. The College has developed a tool that allows pharmacy teams and other stakeholders a view of the aggregate, anonymous medication incident and near miss data on some of the event recording fields that are available through the AIMS program.

In reviewing the data, there are some considerations that should be taken into account. The data is self-recorded and therefore data field selection is dependent on the individual recording. Additionally, the data only reflects the activities of those community pharmacies that have recorded incidents or near misses.

The data from this tool is available to download here.

How to use this tool:

Users can select which data (Events Recorded, Events by Medication Stage, Events by What Happened, Events by why it Happened and Events by Harm Level) by using the buttons on the landing page of the tool.
For each visual, different filters are available to display specific data on the graph (for example Near Miss data only, or moderate harm level only).
At this time, “other” makes up a large proportion of the data for categories of events and contributing factors. Work is underway to improve data collection and more appropriately categorize event information. The default view shows the data for categories of events and contributing factors without “other.” This can, however, be manually selected using the filters.
The graphs will automatically rescale depending on filter selection.
Users can hover over points on graphs to view the exact values.
Any values less than five are not displayed on the graphs and are denoted as not reportable (NR) in the data file.
Registrants can view this information and additional reports along with data on use of CQI tools in the AIMS Pharmapod platform.

About the Data

The College only has access to de-identified aggregate AIMS data for the purpose of reviewing medication event trends and to support shared learning and system-based improvements across the province. The College does not have access to information related to a specific pharmacy or pharmacy professional through this program.

AIMS program data is currently displayed as an Ontario total by year from January 2019 onwards, and the College is working towards sharing AIMS program data by region. It is important to note that retroactive reporting is available in the AIMS platform, so the numbers may change in different reporting periods as pharmacies go back and record incidents for previous months. Throughout this data, events are defined as incidents and near misses recorded.

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.

Near misses are any event that could have led to inappropriate medication use or patient harm but did not reach the patient. Near misses provide valuable insight into areas of risk, and may indicate where systems can be improved to prevent harm. More information on when to record near misses can be found here.

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, that were involved in the event.

Events by What Happened

Events by what happened shows the number 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 shows the contributing factors, such as environmental, staffing, or workflow problem, 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.

Continuous Quality Improvement

This AIMS data should be used for continuous quality improvement to reduce the risk of medication incidents throughout the entire health system. Registrants are encouraged to use this data tool to inform quality improvement work, along with other resources to support medication safety such as:

AIMS platform: continuous quality improvement tools available within the AIMS Pharmapod platform
AIMS Program e-Learning: mandatory e-learning modules 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): preliminary independent analysis of medication incidents and near misses recorded on the AIMS platform

ISMP Canada Safety Bulletins: analysis of ISMP medication incident data and recommendations to improve safety

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