title: Assessing a hospital medication system for patient safety: findings and lessons learnt from trialling an Australian modified tool at Waitemata District Health Board.
abstract: OBJECTIVE
  To undertake a review of Waitemata District Health Board's (WDHB) hospital medication system for patient safety assessment and improvement purposes.
  
  
  METHODS
  A multidisciplinary group rated current WDHB hospital medication systems against the Medication Safety Self-Assessment for Australian Hospitals (MSSA-AH) criterion of 247 aspirational practices using a five point scale ("no" to "fully implemented"). Items with a lesser extent of implementation represented practice gaps. The MSSA-AH database and weighted adjustment scoring system generated an overall hospital score.
  
  
  RESULTS
  Of the maximum possible score that could be obtained had all MSSA-AH practices been implemented, WDHB scored 63% and this was comparable to other demographically similar hospitals in Australia. Lowest scoring practices needing improvement related to staffing. Conflict resolution was a previously unidentified practice gap. Previously identified gaps, such as those relating to electronic medication systems suggested ongoing implementation was required.
  
  
  CONCLUSIONS
  This was the first documented use of the MSSA-AH's in a New Zealand hospital setting and helped WDHB identify areas in need of further improvement. The unique generation of a percentage score helped simplify understanding for non-technical stakeholders. Future repeated assessments would help WDHB track progress. Implicit benefits, such as stakeholder engagement, were observed. The MSSA-AH may be useful in other hospital settings.
authors.affiliation: Quality, Waitemata District Health Board, Auckland, New Zealand. jerome.ng@waitematadhb.govt.nz.
authors.forename: Jerome
authors.initials: J
authors.lastname: Ng
authors.forename: Penny
authors.initials: P
authors.lastname: Andrew
authors.forename: Marilyn
authors.initials: M
authors.lastname: Crawley
authors.forename: Wynn
authors.initials: W
authors.lastname: Pevreal
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Peach
mesh_terms: D003142:Communication; D004348:Drug Labeling; D017408:Guidelines as Topic; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000458:organization & administration / Q000592:standards*; D009520:New Zealand; D010353:Patient Education as Topic; D061214:Patient Safety / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement