Table 3. Description of QIs by type of indicator.

Category	Source	Indicator	Description and/or Numerator, Denominator of indicator
Structure indicators
Safety management	Cheng	Incident reporting and analysis	Description: Organization has a policy and process for reporting and analyzing medication incidents (yes/no).
	Cheng	Prospective medication safety analysis	Description: Organization conducts at least one medication safety related analysis per year (yes/no).
	Cheng	Top 10 medications	Description: List of top 10 medications associated with harm or death medication incidents.
Availability of high alert medication	NSW TAG	Concentrated potassium	Description: Percentage of medication storage areas outside pharmacy where potassium ampoules are available.
	Cheng	Concentrated electrolytes	Description: Concentrated electrolytes (concentrated potassium chloride, potassium phosphate and sodium chloride >0.9%) are removed from patient care areas (yes/no) (percentage of patient care areas where concentrated potassium vials are available).
	Cheng	Narcotic safety	Description: Three criteria: 1. Removal of hydromorphone ampoules or vials with concentration >2 mg/mL (except palliative care) (yes/no); 2. Removal of morphine ampoules or vials with concentrations >15 mg/ mL (yes/no); 3. Standardization and limitation of the number of parenteral narcotic (opioid) concentrations available (yes/no).
Process indicators
Verification	Nigam	Monitoring and reducing adverse drug events by assigning pharmacists on round	Numerator: Number of beds with daily pharmacist participation in interdisciplinary direct patient care.
			Denominator: All beds.
	Nigam	Verification of high alert prescriptions	Numerator: Number of prescriptions/medication orders for high-alert medications that are double-checked and documented by pharmacists before administration.
			Denominator: All prescriptions/medication orders for high alert medications.
	Nigam	Machine readable coding systems for administration	Numerator: Number of doses administered with machine readable code (bar codes).
			Denominator: All doses administered.
Visual reminders	Nigam	Differentiation of high alert prescription medication	Numerator: Number of high-alert prescriptions medications that are differentiated from other medications using flags, highlighting or some other system.
			Denominator: All high-alert prescription medications.
Protocols	Nigam	Administering protocols for high alert prescription medications	Numerator: Number of prescriptions/medication orders for high-alert medications using an administering protocol.
			Denominator: All prescriptions/medication orders for high-alert medications.
	NSW TAG	Chemotherapy protocol	Description: Percentage of patients receiving cytotoxic chemotherapy whose treatment is guided by a hospital approved chemotherapy treatment protocol.
			Numerator: Number of patients prescribed chemotherapy whose treatment was guided by a hospital approved protocol.
			Denominator: Number of patients prescribed chemotherapy in sample.
	NSW TAG	Antibiotic therapy for surgical patients	Description: Percentage of patients undergoing specified surgical procedures that receive an appropriate prophylactic antibiotic regimen.
			Numerator = Number of patients undergoing specified surgical procedures that receive an appropriate prophylactic antibiotic regimen.
			Denominator = Number of patients who had a specified surgical procedure in sample.
	Cheng	Antibiotic prophylaxis	Description: Proportion of select surgical patients (coronary artery bypass graft, cardiac surgery, hip arthroplasty, knee arthroplasty, hysterectomy and vascular surgery) who receive prophylactic antibiotics.
	Cheng	Venous thromboembolism prevention	Description: Proportion of at-risk or eligible patients (undergoing major general or hip fracture surgery) who receive thromboprophylaxis.
Documentation of relevant medication related clinical information	NSW TAG	Postoperative pain management.	Description: Percentage of postoperative patients whose pain intensity is documented using an appropriate validated assessment tool.
			Numerator: Number of postoperative patients whose pain intensity is documented using an appropriate validated assessment tool.
			Denominator: Number of postoperative patients in sample.
	NSW TAG	Adverse drug reactions	Description: Percentage of patients whose known adverse drug reactions are documented on the current medication chart.
			Numerator: Number of patients whose known ADRs are documented on the current medication chart.
			Denominator: Number of patients in sample.
Outcome indicators
Adverse events	QRC Advisor	Medication error rate	Numerator and denominator: not reported
	McLoughling	Medication error	Numerator: Number of patient deaths, paralysis, coma, or other major permanent loss of function associated with a medication error.
			Denominator: The original developer of this indicator conceived of it as sentinel event indicator, i.e. it would reflect events that should never happen. Consequently, the original definition has no denominator. However, if the indicator were applied to the health system level, an appropriate denominator would have to be used to be able to compare rates across countries.
	Cheng	Medication incident types, harm or death incidents by type of error	Description: Frequency of medication incidents resulting in harm or death, categorized according to the type of incident (e.g., incorrect dose, incorrect medication, incorrect patient).
	Cheng	Medication incident rates, harm/death incidents per days of patient care	Description: Proportion of medication incidents that result in harm or death per days of patient care.
	Cheng	Deaths associated with medication incidents	Description: Proportion of total deaths in Ontario that are associated with medication incidents.