Supplementary material A: Questionnaire for basic characteristics
Journal name: Drug Safety
Title: Relevance of foreign alerts and newsletters for the medication errors reporting programme in The Netherlands: An explorative retrospective study
Authors: Ka-Chun Cheung (1,2); Patricia M L A van den Bemt (3); Marcel L Bouvy (4); Michel Wensing (1); Peter A G M De Smet (1,2,5)
Author’s affiliations:
1: Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
2: Royal Dutch Pharmacists Association (KNMP), Den Haag, The Netherlands
3: Department of Hospital Pharmacy, Erasmus MC, Rotterdam, The Netherlands
4: Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for
Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
5: Department of Clinical Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands
Copy of questionnaire:
With this document Ka-Chun will try to collect the basic information. The basic information about the four national reporting systems (CMR, ISMP, ISMP-Canada, NRLS) is needed for the article.
If you have any questions you can email Ka-Chun on k.c.cheung.knmp.nl
I have a request to make to you:-On page 1 you can fill in the contact information of the persons who answers the questions.
-On page 2 you find an overview of the basic information for each national reporting system. Please check if the basic information about your national reporting system is correct.
-On page 3 you will find some questions which needed to be answered.
Please fill in the contact information of the person who answers the questions:
Organisation: ______
Name:______
Email address:______
Thank you for taking time to fill in the questions.
Overview of the basic information of the reporting systems in each country
Country / US / Canada / UK / NetherlandsName of reporting system / ISMP Medication Errors Reporting Programme / Canadian Medication Incident Reporting and Prevention System / National Reporting and Learning System, NRLS / Central Medication Incidents Registration, CMR
Year of the development / 1975 / 1999 / 2005 / 2006
Organisation / Independent organisation / Independent organisation / Government / Independent organisation
Other types of incidents the system collects
(beside medication incidents) / Device errors
Hazardous condition / Only medication incidents / All types of incidents / Only medication incidents
Voluntary to report to the system / ● / ● / ● / ●
Share information with government authorities / ● / ● / ●
Types of care organisations that could report
Ambulance service / ● / ●
Community pharmacy / ● / ● / ● / ●
Community optometry / optician service / ●
Dental service / ●
General practice / ● / ● / ●
Hospital / ● / ● / ● / ●
Mental health care / ● / ● / ● / ●
Residential / home / ● / ●
Patients, relatives, cares / ● / ● / ●
Public / ● / ●
Type of sharing information
Alert / ● / ● / ● / ●
Newsletter / ●* / ● / ? / ●
Annual report / ? / ? / ●
List of ‘look-alike/sound-alike’-medicines / ? / ? / ●
Guidelines / ● / ? / ?
“High-alert” Tall-Man Lettering List / ●
Medium for sharing information
Post / ● / ? / ?
Website / ● / ● / ● / ●
Email / ● / ? / ? / ●
Social media / ● / ? / ?
Conferences / meetings / ●
Frequencies of output
Alert / Ad hoc / ? / ? / Ad hoc
Newsletter / Biweekly * / ? / ? / Quarterly
Annual report / ? / ? / Yearly
List of ‘look-alike/sound-alike’-medicines / ? / ? / Ad hoc
Guidelines / Ad hoc / ? / ?
“High-alert” Tall-Man Lettering List / Ad hoc
* ISMP USA has five types of newsletters: Acute care (biweekly), community care (monthly), nurse advise (monthly), long-term care (half yearly), and consumer (bimonthly).
Questions to collect basis information
-What kind of output does your organisation disseminate?
- Newsletter: YES / NO
- Alert:YES / NO
- Annual report:YES / NO
- ______
- ______
- ______
- ______
-What are frequencies of the different kind of output?
- Newsletter: yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- Alert:yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- Annual report:yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- ______yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- ______yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- ______yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- ______yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
- ______yearly / quarterly / half yearly / bimonthly / monthly / ad hoc
-What are the factors for decision to disseminate output?
- ______
- ______
- ______
-Who is maintaining the reporting system?
- Government
- Independent organisation
- Health professional association
- ______
-What kind of medium is used for sharing information / guidance / output?
- Post (mail)YES / NO
- WebsiteYES / NO
- EmailYES / NO
- Social mediaYES / NO
- ______YES / NO
- ______YES / NO
- ______YES / NO
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