Identifying Risk in Your Organization: Does Error Reporting Capture Everything?


Most health care organizations use voluntary error and adverse event reporting programs to learn about potential safety risks and the circumstances of individual errors. The 2006 Institute of Medicine report, Preventing Medication Errors, stated that errors need to be reported and analyzed if improvements in care are to be achieved. But the value of the reporting of medication errors within healthcare organizations is often limited by the cumbersome and time-consuming nature of internal error reporting methods, and the lack of methodology used to sort and analyze error data. This webinar is designed to assist organizations in the effective use of internal reporting programs. During the webinar, the importance of gathering key information will be reviewed, as well as the value of applying ISMP’s system-based approach to error analysis. Also, the negative impact that punitive systems and poor feedback mechanisms has on error reporting and error reduction efforts will be addressed. Participants will learn how to identify medication safety risk, beyond the use of error reporting. A variety of techniques, including proactive, concurrent, and reactive methods will be discussed as well as their advantages and disadvantages.

Intended Audience:

  • Quality and Risk Management Leaders
  • Administrators with Pharmacy and Nursing Oversight
  • Medication Safety and Patient Safety Officers
  • Pharmacists
  • Pharmacy Technicians
  • Nurses 
  • Physicians

Learning Objectives:

Following completion of this activity, participants will be able to:

  1. Describe how ISMP receives and analyzes medication error reports and what we have learned from medication error information.
  2. Identify factors that may cause healthcare practitioners to be reluctant to report an error.
  3. State how the underreporting of errors as well as the lack of a thorough investigation prevents effective system enhancement and improvement of patient outcomes.
  4. Identify useful methods of collecting, analyzing, and using data about medication safety.

Introduction and Overview:

Susan Paparella, RN, MSN, Vice President, ISMP


Matthew Grissinger, RPh, FISMP, FASCP, Director, Error Reporting Programs, ISMP



Purchase Activity

CE Accreditation

Release Date: November 9, 2017
Expiration Date: November 9, 2018 

Pharmacists ad Pharmacy Technicians

acpe logo

This CE activity is jointly provided by ProCE, Inc. and ISMP. ProCE is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. ACPE Universal Activity Number 0221-9999-17-430-H05-P/T has been assigned to this knowledge-based, home-study activity (initial release date 11-9-17). This CE activity is approved for 1.5 contact hours (0.15 CEUs) in states that recognize ACPE providers. Completion of an evaluation and post-test is required to receive CE credit. Proof of completion will be posted in NABP CPE Monitor profiles. No partial credit will be given.


This activity is approved for 1.0 hour of Nursing Continuing Education.


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