15 hospital best practices for medication safety: ISMP

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The Institute for Safe Medication Practices outlined 15 strategies for reducing medication errors in clinical settings in its 2026-2027 “Targeted Medication Safety Best Practices for Hospitals.” The update includes three new best practices and 12 carried forward from previous cycles.

ISMP launched the Targeted Best Practices program in 2014 to help hospitals implement “low-effort, high-impact safety interventions.” This year’s update draws on national medication error reports, safety assessments and expert panel input to close long-standing system gaps where preventable errors persist despite known solutions.

Here are the three new focus areas and corresponding recommendations from the guideline:

  1. IV push medication safety: Expand use of ready-to-administer (RTA) products; avoid reconstitution outside the pharmacy; and eliminate dilution of medications in saline flush syringes. Infusion pumps with dose error-reduction systems should be used when injection rates are impractical by hand.
  1. Barcode scanning performance: Proactively test barcode functionality; remove “proxy” scanning workarounds; and address scanning failures through clear escalation pathways and system performance reviews.
  1. Safety culture: Move beyond tracking error rates and instead implement “good catch” programs; increase near-miss reporting; maintain formal error-reduction plans; and act on safety culture survey findings.

The full set of 15 best practices includes monitoring outcomes where high-alert medications are used, implementing EHR-based safeguards, order standardization and more. 

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