Medication safety monitoring inspections in public acute hospitals publication statement August 2017

Date of publication:

Two inspection reports on medication safety in public acute hospitals have been published today by the Health Information and Quality Authority (HIQA). HIQA monitors medication safety in hospitals against the National Standards for Safer Better Healthcare. Inspections were carried out in July 2017 at St. James’s Hospital in Dublin and Portiuncula University Hospital in Ballinasloe.

St. James’s Hospital, Dublin

An announced inspection of St. James’s Hospital, Dublin, was carried out on 4 July 2017. HIQA found on the day of inspection that the hospital had an established medication safety programme with effective governance arrangements, systems, processes and practices in place to support medication safety in the hospital. It was evident that this had been progressed over a significant period of time and driven by effective local leadership, executive management support and resource allocation.

St. James’s Hospital had a system for reporting and addressing medication errors and near misses and promoted an open reporting culture for learning from medication-related incidents and near misses. However, scope for improvement of the incident reporting rates was identified by the hospital.

Inspectors saw evidence of significant investment by the hospital in technology, structures, resources and supports for medication safety. In addition, the hospital’s medication strategy incorporated both a reactive and proactive approach to strengthen medication safety intelligence and enhance patient safety.

Portiuncula University Hospital, Ballinasloe

An announced inspection of Portiuncula University Hospital, Ballinasloe, took place on 13 July 2017. On the day of inspection, HIQA found that the structures and systems in place to support medication safety at the hospital needed to be strengthened. The hospital did not have a formal medication safety programme in place that was underpinned by an overarching medication safety strategy and prioritised on the basis of identified risk.

HIQA found that the clinical pharmacy service in place at the hospital was not comprehensive. At the time of the inspection, the Emergency Department and paediatric and maternity wards did not have a dedicated clinical pharmacy service. This represents a significant risk to patient safety. Inspectors concluded that, in the short term, it may be possible to target existing resources towards an inpatient clinical pharmacy service for maternity and paediatric services, which are high risk areas from a medication safety perspective.

Inspectors also found that there was scope for improvement in working to promote a more effective culture of medication-related incident reporting at Portiuncula University Hospital. Medication related incidents were not discussed by the hospital’s Drugs and Therapeutics Committee, resulting in poor governance and oversight of these incidents.

Notes for Editors

  • HIQA’s medication safety monitoring programme, which commenced in November 2016, aims to examine and positively influence the adoption and implementation of evidence-based practice in public acute hospitals regarding medication safety.
  • HIQA’s Guide to the Health Information and Quality Authority’s Medication Safety Monitoring Programme in Public Acute Hospitals outlines the requirements for service providers under phase one of the inspection programme.