MSSA Hospital, Canadian Version IV Draft 2026-03-30 Introduction

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The Medication Safety Self-Assessment for Hospital (MSSA-Hospital) has been updated from the 2016 version by the Institute for Safe Medication Practices Canada (ISMP Canada), supported by the Canadian Medication Incident Reporting and Prevention System (CMIRPS).

The MSSA-Hospital is designed to facilitate evaluation of the safety of hospital medication management systems by:

• Heightening awareness of the core characteristics of a safe medication system
• Identifying vulnerabilities and opportunities for improvement related to medication system safety
• Creating a baseline measurement of the current level of implementation of recommended strategies for medication safety
• Monitoring progress over time through periodic repeated measurement to see where improvements have been achieved and where challenges remain

STRUCTURE

The self-assessment is divided into 7 key elements related to safe medication use in hospital. Each key element is defined by one or more of 17 core characteristics of a safe medication system. There are 216 self-assessment items to help hospital teams evaluate the level of implementation of recommended strategies for medication safety.

DEVELOPMENT

Topics and content for this MSSA have been derived from a variety of sources, including

• Published literature on medication safety initiatives/strategies in the hospital setting
• ISMP Canada resources and learning from analysis (e.g., Safety Bulletins, MSSA: Focus on "Never Events” in Hospitals and Ambulatory Care Centres)
• Health Standards Organization (HSO) CAN/HSO 3001:2026 Medication Management*
• ISMP (US) resources (e.g., ISMP Targeted Medication Safety Best Practices for Hospitals)

Note: ISMP Canada, HSO, and Accreditation Canada have complementary mandates to strengthen patient safety. ISMP Canada has worked with HSO to indicate where medication safety self-assessment items within this document are aligned with the CAN/HSO 3001:2026 Medication Management. These items are identified with this accreditation symbol. HSO supports the use of the MSSA-Hospital as a comprehensive program to assist hospitals in evaluating the safety of their medication systems. ISMP Canada’s MSSA does not replace any of Accreditation Canada’s assessment processes. Please consult Accreditation Canada directly for any questions related to their assessment.

Development of the assessment content was supported by an expert Advisory Panel which included representation from patients/caregivers, pharmacy and nursing regulatory authorities, academia, health care providers (e.g., pharmacists, pharmacy technicians, nurses, physicians), information technology, medication safety, Healthcare Insurance Reciprocal of Canada (HIROC), and Health Standards Organization (HSO). Validation testing of this MSSA was conducted by multiple hospital sites.