The AIMS Safety Insights Group (SIG) is a multi-stakeholder group with pharmacy and data analytic expertise that works with the College and the Ontario Drug Policy Research Network (ODPRN) to provide guidance and actionable recommendations for pharmacy professionals, the pharmacy sector and other health system stakeholders on how to improve medication safety. The AIMS SIG is responsible for identifying recommendations that will be shared through regular reports based on data analysis which will include key findings and proposed actions for pharmacy professionals and other stakeholders. The College supports the writing of reports, sharing findings and implementing recommendations that impact the AIMS Program.
AIMS SIG Reports – General format and objectives:
There was a general consensus regarding the content, layout, and format of the SIG bulletin. It was recognized that this is the first report and that it is important this will be an iterative process for developing a bulletin format and template that can be applied to future bulletins.
The group suggested that the bulletin needs to be impactful, short, and quick to read which may not fit on two pages as initially suggested.
- There is a need to get the correct messaging to registrants while ensuring reader focus and time constraints (always keep the reader in mind while developing the bulletin).
- If the main area of focus is short then it would be possible to add other focus areas to the bulletin, if needed. An initial graphical mock-up of the bulletin is needed for the SIG to review which should be tested with a group of intended end-users.
- Pharmacists are very busy and would prefer the bulletin in a format that is easy to read so maybe consider moving the ‘About the SIG’ section to the end, maybe as a footer and have the ‘Executive Summary’ section at the start of the report.
The methods used to collect and analyse AIMS data should be described within the bulletin. The community pharmacy context is important so therefore it should contain actionable insights that could be feasibly incorporated into a pharmacist’s workflow, and possible measurement strategies for proposed interventions for improving medication safety. There could be consideration of developing a companion document to supplement the bulletin.
Background general information, context, information on the problem (the WHY):
Consider including within this and future bulletins:
- Case studies so that you could increase registrants’ understanding of the recommendations and facilitate translating recommendations into their routine practice and processes
- Consequences of not adhering to best practices
Links, Resources and Tools:
The bulletin should include resources from various jurisdictions which could contain best practices that could be applicable to the Ontario context e.g., WHO Global Patient Safety Alerts and the Antimicrobial stewardship programmes in healthcare facilities in low-and middle-income countries: A WHO practical toolkit.
Analysis Prioritization and Findings
The April and June AIMS SIG meetings focused on determining an initial area of focus and reviewing more in depth analysis for this area.
The objective of the April AIMS SIG meeting was to review the AIMS analysis by drug and drug class to determine one initial area of focus. Through meeting discussion and polling, as well as a follow up poll to confirm the selection, the group decided to focus on the antibiotic drug class for the first AIMS SIG bulletin.
Features of the antibiotic drug class were discussed, such as the potential for antibiotics to be dispensed outside a patient’s usual pharmacy, often after coming from a hospital setting, the acute nature of antibiotics and the fact that this means they are dispensed to a larger number of unique patients. The AIMS SIG decided that these unique features made antibiotics a meaningful topic for the first bulletin.
To support further discussion and practice recommendations for the antibiotic drug class, further analyses were conducted by ODPRN between the April and June meetings.
The objective of the June meeting was to review the AIMS analyses for the antibiotic drug class and identify key insights that can be translated to recommendations for practice. The group reviewed additional analyses of the antibiotic drug class and discussed areas that may benefit from practice recommendations. The importance of ensuring recommendations are aligned with best practices and supported by the AIMS data was emphasized.
Analysis Review and Prioritization
The February and March AIMS SIG meetings focused on reviewing an initial analysis of the AIMS data. These initial analyses aimed to determine key areas of focus and areas to gain a deeper understanding of the data, and initial discussions of implications of the analysis for practice.
The objective of the February AIMS SIG meeting was to review the initial analysis of the AIMS data, raise any questions about the analysis and begin discussions about areas of focus. The group reviewed a broad analysis of the AIMS data, including analysis of drugs and drug classes, event categories and contributing factors involved in a higher proportion of events.
The group discussed opportunities for improvement in reporting and data collection in the AIMS program, including clarifying in the platform the difference between drugs prescribed and dispensed, and reducing the selection of “other” in reporting for the event type and contributing factors fields.
The importance of emphasizing the value of reporting medication events to collect data from a broader number of pharmacies was also raised. The challenge of many reports coming from a relatively small number of pharmacies was noted as a general challenge to medication event reporting.
Between the February and March meetings, the AIMS SIG members were asked to review the analysis presented at the February meeting and, using a structured survey completed independently, recommend areas of the analysis for the AIMS SIG to focus on. These recommendations were used as a starting point for the March meeting discussion.
The objective of the March meeting was to continue review of data and suggest and prioritize areas for in-depth analysis. The areas of analysis discussed at this meeting focused on drug and drug classes with higher proportion of higher harm events, contributing factors and sub factors that appeared most frequently, drugs dispensed with a higher proportion of events, and common event types overall.
The AIMS SIG discussed their interest in specific drugs and drug classes, as well as better understanding the severity of harm level associated with incidents. The group also discussed their interest in learning more about demographics of patients involved in medication incidents and the potential impacts of the COVID-19 pandemic on reporting.
The first AIMS Safety Insights Group (SIG) meeting focused on orienting members to the goals, scope and responsibilities of the AIMS SIG, and the expectations for analysis and reporting lifecycle. This group will provide guidance and actionable recommendations for pharmacy professionals, the pharmacy sector, and other stakeholders on how to improve medication safety. This will be done by reviewing data analysis, directing further in-depth analysis, identifying key findings, and producing robust medication safety reports for Ontario.
The roles and responsibilities of the AIMS SIG, the Ontario Drug Policy Research Network (ODPRN) and the College, as outlined in the Terms of Reference, were reviewed. The group noted that a group like the AIMS SIG working with the regulatory body is not typical and presents an interesting learning experience.
Members discussed the importance of learning from the lessons of the AIMS Response Team, the group previously responsible for analysis of medication incidents entered into the AIMS platform. The need for a deeper level of data analysis that could not be achieved with aggregate data alone, and dedicated and enhanced data analysis support was recognized. This will be filled moving forward by the data analysis role of the ODPRN working with the AIMS SIG. The appropriateness of data fields was also identified as a barrier to high quality analysis and recommendations, and members of the AIMS SIG offered to collaborate with the College to share their own lessons learned as part of the ongoing continuous quality improvement of the AIMS data fields.
The key output of the AIMS SIG will be regular medication safety reports. The group reviewed the proposed cycle of meetings to discuss the data analysis, findings, actions and the final report, and the key goals for each meeting that will be required to produce these reports. The ODPRN provided an overview of the expectations of analysis for the AIMS SIG. The objectives of the analysis, phased plan for analysis and outline of future work were presented.