MERP Should be a Living Document

merp program

When I first “officially” started in the medication safety world, I held primary ownership for the MERP. As a pharmacist, I could clearly identify vulnerabilities discovered through various means. It seemed easiest and most natural for me as the Medication Safety Officer to add initiatives and remove initiatives once things had been improved. I would get other disciplines involved in the improvements of course, but no one else got involved when it came to the official MERP initiatives documents. Needless to say, our friendly neighborhood California GACH surveyor identified this as a gap in our program. The MERP documents must be managed and reviewed by the committee overseeing the MERP responsibilities which, in many cases, is the Medication Safety Committee.

One of the requirements is an annual review to assess the effectiveness of implementation for each of the eleven procedures and systems. Those eleven procedures and systems are:

  1. prescribing
  2. prescription order communication
  3. product labeling
  4. product packaging & nomenclature
  5. compounding
  6. dispensing
  7. distribution
  8. administration
  9. education
  10. monitoring
  11. use

The Medication Safety Committee is the group that holds responsibility for the review. The review consists of evaluation of what initiatives go on the plan, where the deficiencies and weaknesses are, the follow up on improvements, and the discussion surrounding the effectiveness in reducing harm. MERP is a multi-disciplinary effort and facilities will be surveyed to that expectation.

For those of you outside California, do you have similar requirements for programs to improve medication safety? If there is nothing in regulations, I hope your facility has a program for improvements just because it is the right thing to do.

Terri Vidals
Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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