PT - JOURNAL ARTICLE AU - Leon, Catherine AU - Hogan, Helen AU - Jani, Yogini H TI - Identifying and mapping measures of medication safety during transfer of care in a digital era: a scoping literature review AID - 10.1136/bmjqs-2022-015859 DP - 2023 Nov 03 TA - BMJ Quality & Safety PG - bmjqs-2022-015859 4099 - http://qualitysafety.bmj.com/content/early/2023/11/03/bmjqs-2022-015859.short 4100 - http://qualitysafety.bmj.com/content/early/2023/11/03/bmjqs-2022-015859.full AB - Background Measures to evaluate high-risk medication safety during transfers of care should span different safety dimensions across all components of these transfers and reflect outcomes and opportunities for proactive safety management.Objectives To scope measures currently used to evaluate safety interventions targeting insulin, anticoagulants and other high-risk medications during transfers of care and evaluate their comprehensiveness as a portfolio.Methods Embase, Medline, Cochrane and CINAHL databases were searched using scoping methodology for studies evaluating the safety of insulin, anticoagulants and other high-risk medications during transfer of care. Measures identified were extracted into a spreadsheet, collated and mapped against three frameworks: (1) ‘Key Components of an Ideal Transfer of Care’, (2) work systems, processes and outcomes and (3) whether measures captured past harms, events in real time or areas of concern. The potential for digital health systems to support proactive measures was explored.Results Thirty-five studies were reviewed with 162 measures in use. Once collated, 29 discrete categories of measures were identified. Most were outcome measures such as adverse events. Process measures included communication and issue identification and resolution. Clinic enrolment was the only work system measure. Twenty-four measures captured past harm (eg, adverse events) and six indicated future risk (eg, patient feedback for organisations). Two real-time measures alerted healthcare professionals to risks using digital systems. No measures were of advance care planning or enlisting support.Conclusion The measures identified are insufficient for a comprehensive portfolio to assess safety of key medications during transfer of care. Further measures are required to reflect all components of transfers of care and capture the work system factors contributing to outcomes in order to support proactive intervention to reduce unwanted variation and prevent adverse outcomes. Advances in digital technology and its employment within integrated care provide opportunities for the development of such measures.All data relevant to the study are included in the article or uploaded as supplementary information.