Objectives: Limited data exist regarding staff's knowledge and perceptions of high alert medications (HAMs) and associated procedures. Objectives of this study were to conduct an initial assessment of institution-specific HAM knowledge among pharmacy, nursing, and medical staff; implement interventions to enhance staff knowledge of HAMs; and conduct a similar assessment 1 year later to determine if interventions successfully enhanced HAM knowledge.Methods: A 6-question electronic survey was distributed to 1006 pharmacy staff, nurses, and physicians in June 2009. In response to results achieved, HAM-related interventions were implemented over a 6-month period. A similar electronic survey was distributed to hospital staff 1 year later to determine any change in HAM knowledge.Results: A total of 203 staff completed the presurvey (20% response rate), whereas 170 completed the postsurvey (17% response rate). Before the HAM interventions, 42.9% of respondents expressed confidence in their knowledge of HAMs and the procedures defined by the institution. This increased to 73.5% after the interventions (P < 0.001). More respondents correctly identified HAMs and safety procedures on postsurveys: insulin IV bolus (83.3% vs. 92.4%; P < 0.01), neonatal medications (79.3% vs. 88.2%; P < 0.05), total parenteral nutrition (57.1% vs. 73.5%; P = 0.001), and "documentation of 2 independent registered nurse checks for HAM IV infusion rate changes" (76.4% vs. 92.9%; P < 0.001).Conclusions: An assessment of staff HAM knowledge and handling procedures allows for customized interventions for institution-specific HAM improvements. Hospital staff knowledge of HAMs increased 1 year after implementing interventions.