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 Mallow General Hospital in Cork and Cappagh National Orthopaedic Hospital in Dublin.

Mallow General Hospital, Cork

An announced inspection of Mallow General Hospital, Cork was carried out on 19 July 2017. HIQA found that hospital management had worked to support and progress a medication safety agenda at the hospital through the formation of a Medication Management Committee towards the end of 2016. However, a formal medication safety strategy was not evident at the time of the inspection and the medication safety programme in place at Mallow General Hospital remained significantly underdeveloped and limited by resource constraints.

Inspectors found that the level of reporting of medication-related incidents and near misses at the hospital was low and there was significant scope for improvement in developing and promoting a more effective culture of medication incident and near miss reporting.

It was also determined that a formalised link between the pharmacy sites at Mallow General Hospital and Cork University Hospital had the potential to serve as a reciprocal source of peer support, information sharing and progression of a medication safety agenda between the hospital sites. This was not in place at the time of inspection.

Inspectors found that senior management at Mallow General Hospital endorsed and supported the promotion and strengthening of a culture of quality and safety in relation to medication safety. However, many of the opportunities identified for improvement require strategic, combined and targeted action by Mallow General Hospital, the Cork University Hospital Group and the South/South West Hospital Group to address the issues arising and implement an effective medication safety agenda at Mallow General Hospital.

Cappagh National Orthopaedic Hospital, Dublin

An announced inspection of Cappagh National Orthopaedic Hospital, Dublin took place on 19 July 2017. On the day of inspection, HIQA found that the medication safety agenda was being actively progressed at the hospital through the work of the Medication Management Committee. However, the Drugs and Therapeutics Committee did not hold the required meetings or have the appropriate membership related to the functions of the hospital to provide a suitable governance arrangement for medication safety. As a result, inspectors determined that the hospital needs to review the current governance oversight for medication safety by the Drugs and Therapeutics Committee within the hospital as a priority.

The hospital demonstrated a variety of quality improvement initiatives which had been implemented in relation to medication safety. Inspectors found that elements of medication safety were evaluated through audit at Cappagh National Orthopaedic Hospital and an audit plan was in place for 2017. However, these audits were not formally aligned to a medication safety strategy or centrally coordinated.

In addition, inspectors found that medication-related incidents and near misses were tracked, trended and graded, and where trends were identified, action was taken to prevent reoccurrence.

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.