Pharmacies > AIMS (Assurance and Improvement in Medication Safety) Program

AIMS (Assurance and Improvement in Medication Safety) Program

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The Assurance and Improvement in Medication Safety (AIMS) Program puts in place a mandatory consistent standard for medication safety for all pharmacies in the province. Its goal is to support continuous quality improvement (CQI) and to reduce the risk of patient harm caused by medication incidents in, or involving, Ontario pharmacies.

The purpose of the AIMS Program is to identify trends and develop quality improvement solutions and recommendations to assist pharmacy professionals in reducing the risk of patient harm caused by medication incidents.

Changes to the AIMS Program were approved by the Board in 2025. For more information on what pharmacies are required to do in 2026 and 2027 as we evolve the AIMS Program, please see the Changes to the AIMS Program webpage.

Program Requirements

There are four main components of the AIMS Program:

  • Report. Pharmacy professionals must anonymously record all medication incidents and near misses. In 2026, pharmacies can record this information in their preferred format. As of January 1, 2027, pharmacies must use a medication incident reporting platform (the platform must meet the College’s criteria and provide daily uploads to the National Incident Data Repository for Community Pharmacies).
  • Document. Pharmacy professionals must document appropriate details for medication incidents and near misses in a timely manner. CQI plans and outcomes of staff communications and quality improvements implemented must also be documented.
  • Analyze. When a medication incident or near miss occurs, pharmacy professionals analyze the incident in a timely manner for causal factors and commit to taking appropriate steps to minimize the likelihood of recurrence of the incident. Starting on January 1, 2027, pharmacies must complete a safety self-assessment at least once every two years.
  • Share Learnings. There should be prompt communication of appropriate details of a medication incident or near miss, including causal factors and actions taken as a result, to all staff. The development and monitoring of CQI plans and outcomes should be supported. Starting on January 1, 2027, CQI meetings must be held at least once every quarter.

Medication incidents: Any preventable event or error that reaches a patient and that may cause or lead to inappropriate medication use or patient harm.

Near misses: An event that could have led to inappropriate medication use or patient harm but was intercepted before it reached the patient.

Standards and Expectations of Pharmacy Professionals and Pharmacy Managers

The College’s expectations of registrants regarding medication safety are outlined in the supplemental Standard of Practice (sSOP). All pharmacists and pharmacy technicians should understand their obligations under the sSOP and actively facilitate the integration of the AIMS Program requirements in their pharmacy.

The Standards of Operation, which all pharmacies must meet, include standards related to the implementation of a safe medication management system and quality improvement program.

Designated Managers in community pharmacies and designated contacts in hospital pharmacies are responsible for:

  • Cultivating and fostering a safety culture grounded in continuous quality improvement and shared learning
  • Promoting open and honest discussions about medication events
  • Becoming familiar with the requirements under the sSOP and Standards of Operation and educating staff in their pharmacies.

Community pharmacies must implement the AIMS Program in a manner that supports pharmacy professionals in meeting the requirements under the sSOP. Hospital pharmacies must support pharmacy professionals in meeting the requirements under the sSOP by reporting incidents involving medications to the safety incident management system at the hospital.

FEATURED RESOURCES

FAQs

  • The goal of the Assurance and Improvement in Medication Safety (AIMS) Program is to reduce the risk of patient harm caused by medication incidents in, or involving, Ontario pharmacies.

    The program sets out a mandatory standard for medication safety to enable all pharmacies to use a consistent approach to reporting, documenting, analyzing and sharing learnings related to medication incidents. It supports a safety culture that enables continuous quality improvement at an individual pharmacy level and system wide.

    Starting in 2027, information collected through the incident management platform and provided to the National Incident Data Repository for Community Pharmacies (NIDR) will also help to identify trends and develop recommendations for pharmacy professionals across the country.

  • All registered pharmacy professionals must meet the requirements of the supplemental Standard of Practice.

    All community pharmacies are required to meet the requirements of the AIMS Program.

    In accordance with the Standards of Operation, hospitals must support pharmacy professionals in meeting the requirements of the supplemental Standard of Practice by reporting incidents involving medications to the incident management system.

  • If a medication incident occurs, it is the College’s expectation that the pharmacy staff act promptly to provide appropriate support for the patient. They must record the incident and activate the quality improvement process. This includes documenting what happened, analyzing the incident to determine contributing factors, working to identify how it can be prevented from recurring, and taking the necessary steps to accomplish that goal by applying and sharing quality improvement strategies with their teams.

    The same process must also be followed for near misses, which provide valuable insight into areas of risk, and may indicate where systems can be improved to prevent harm.

  • If a potential error is caught outside of the established processes and procedures at the pharmacy but before the prescription reaches the patient, it should be recorded as a near miss. Established processes and procedures could include the technical and therapeutic signoffs and/or any other regular process in place to catch errors such as input or DIN errors.

    Regardless of when a near miss is caught, if it is noted that similar errors are re-occurring on a frequent basis, this may indicate that the processes and procedures implemented into the workflow are not effective and should be reviewed.

    The extent to which near misses are recorded will be a professional judgment decision of the Designated Manager in consideration of the nature of the near miss, its implication for patient safety, and the extent to which it is recurring.

  • Only aggregate and de-identified data collected through the program will be reported publicly. Data reports from the years 2020 to 2024 are available.

    Starting in 2027, data reported by Ontario pharmacies in their incident management platforms will be uploaded to ISMP’s National Incident Data Repository for Community Pharmacies. This data will be used nationally to help identify widespread risks and trends and enable more effective coordinated interventions. It will also support consistency in safety practices, policy development, and shared learning across jurisdictions, ultimately improving patient safety across the country.

  • To fulfill the requirements of the AIMS Program, pharmacies must have access to an incident management platform that supports continuous quality improvement by January 1, 2027. It must meet the Incident Management Platform Criteria set out by the College.

  • No. The College only has access to aggregate data provided through the National Incident Data Repository. However, pharmacy staff may be asked to provide proof (after January 1, 2027) that they have an incident management platform in place that meets the College’s criteria and that it is being used in alignment with the AIMS Program requirements.

  • No information that could identify a patient is submitted from a pharmacy’s incident management platform to the National Incident Data Repository (NIDR). Only the patient’s age range and gender will be shared. It is the responsibility of the pharmacy to ensure that there is no identifiable information provided in any free text fields.

    As health information custodians, pharmacies are accountable for taking reasonable steps to protect personal health information and keep it secure.

  • As of January 1, 2027, registered pharmacy staff (pharmacists and pharmacy technicians) must have a unique login at their primary place of practice. Occasional staff, such as relief pharmacists and pharmacy technicians, would not be required to have individual logins. Unregulated staff, such as pharmacy assistants, are not required to have access; however, access may be granted at the discretion of the designated manager when appropriate.

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