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This international snapshot provides important data about the level of implementation of system-based safeguards in oncology practice, key improvement opportunities, and represents a baseline for future improvement efforts. A collaborative approach to identifying vulnerabilities and developing solutions for safe medication use in oncology will enhance the care of patients with cancer internationally.

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MEDICATION SAFETY HAS COME TO THE FOREFRONT OF health care agendas, a shift that has been driven in part by adverse events studies reporting the incidence of preventable medication errors in hospitals, 1 long-term care facilities, 2 and the community. 3,4,5 Recent initiatives to improve patient safety in acute care settings, 6 particularly medication reconciliation, 7,8 are beginning to have an impact on community pharmacists. It is therefore important for all community pharmacists to be aware of patient safety initiatives and consider what medication safeguards may be appropriate in their own pharmacies. Formal pharmacy education programs do not typically include information on safe medication systems and how we as pharmacists can help to ensure safety in our own practices. We have been taught to rely on careful checking -for example, checking labels 3 times during the dispensing process -but we have not been exposed to the concepts of medication system safety and how our environment, processes, equipment, and other factors can affect dispensing accuracy.Pharmacists have also not learned how human factors engineering principles can influence our actions and how such principles can be used in implementing safeguards to minimize the risk of error at our practice sites. Human factors such as lighting, 9 interruptions, 10 and distractions 11 are known to affect dispensing accuracy. Incorporating this knowledge into the design of our pharmacies and our workflow patterns can help to enhance our accuracy. Look-alike and sound-alike product names and packaging have been implicated as root causes in medication errors in the dispensing and administration stages of the medication use process. For example, an earlier column in this series described a dispensing error that originated when a look-alike product was picked at the warehouse. 12

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