Medication errors result in 9,000-24,000 preventable deaths annually in Canada and many more instances of harm. Of all the stages of the medication process, order writing has the highest amount of errors (39-49%).
The Northern Health Safe Medication Order Writing (SMOW) Clinical Practice Standard has been available since 2013, as endorsed by the NH Medical Advisory committee. In addition, a 20 minute Safe Medication Order Writing E-Course for Prescribers is available on the NH Leaning Hub. Since the availability of these resources, there has been some promotion through NHMAC and physician meetings. However, physician leadership has indicated that detailed audit reporting (as well as feedback process) would be beneficial to improve adherence to this policy. Accreditation Canada is now also requiring regular monitoring.
Previously, pharmacy collected SMOW adherence data in ScanRx. However, this system had limitations and requires fully manual order retrospective. Order review and data has been insufficient, qualitative and random at best. Therefore, the auditing system has been moved to Cerner. Pharmacy has been collecting data since February 2018 and is ready to begin reporting to physicians.
For detailed information on SMOW Auditing & Reports, please see the presentation given at NHMAC by Nicole Dahlen.
You can also view the poster for top 10 reasons orders are not meeting SMOW requirements.