Transforming and Supporting Patient Care - Health Professions ...

64Chapter 3 - A New Drug Approvals Framework For OntarioThe impact of drug-related errors on both health and system outcomes iswell-documented. Virtually every jurisdiction in and outside Canadaappears to share common and prevalent adverse events in medicationprescribing, dispensing, administration, management and use. In their 2007report, Optimal Prescribing and Medication Use in Canada: Challenges andOpportunities, Sketris and others note that “both suboptimal prescribingand variation in prescribing practices exist in Canada, leading to under-use,overuse and inappropriate use of drugs”. 30The U.S. Institute of Medicine report, To Err Is Human (1999), helped spark awidespread call to action with its estimate that between 44,000 and 98,000U.S. citizens die each year as a result of medication errors. While Canadadid not immediately follow suit in highlighting this issue, mostly due to alack of data, now the country and each of its provinces have patient safetystrategies in place due to growing awareness and concern among thepublic. 30 Approximately one in every ten Canadians, according to a recentinternational health survey, reported receiving the wrong medication ordose from a health professional in the previous two years. 31Patient safety is a prime concern in considering new or expanded authoritiesin the area of non-physician prescribing and drug administration. HPRAC’sliterature review referenced a substantial body of literature focused onphysicians, nurses and pharmacists. However, reviews specifically targetingpatient safety found limited information on prescribing and drugadministration by health professions other than physicians.Still, there is strong consensus among those whom HPRAC consulted thatincreased patient safety should be a fundamental outcome of HPRAC’sreview and recommendations.HPRAC heard in its key informant interviews that the possibility ofincreased risks of errors as a result of multiple prescribers andprofessionals dispensing medications to patients is a particular concern.To mitigate this risk, the following strategies were identified:• Clearly define shared protocols and standards of care; Developinterprofessional education requirements for a common curriculumon medication;• Provide access to common sources of information on safe medicationpractices and to common clinical decision support tools;• Develop more up-to-date processes for care coordination(technological, operational etc.) that take into account multipleproviders;• Effectively sharing clinical information (health records) amonghealth professionals;30Canadian Patient Safety Institute.31Patient Safety in Canada: An Update (August 2007), Canadian Institute for Health Information, p.18;viewable at http://www.cihi.ca/cihiweb/en/downloads/Patient_Safety_AIB_EN_070814.pdf.HPRAC Critical Links January 2009