Medical Staff Portal

High Alert Medications


What are High Alert Medications (HAMs)?

The Institute for Safe Medication Practices (ISMP) defines HAMs as drugs that bear a heightened risk of causing significant patient harm when they are used in error. Although mistakes may or may not be more common with these drugs, the consequences of an error are clearly more devastating to patients. Covenant Health has developed a HAM list adopted from the ISMP HAM list and a policy suite.

Covenant Health Medication Managment Safety Team (MMST)

The MMST's role is to lead and support medication quality and safety initiatives across Covenant Health. The MMST is responsible to ensure compliance in the labeling, storage and availablity of HAMs in Pharmacy Department and Patient Care Areas.

High Alert Medications

Required Organizational Practice Exceptions (ROPE)

Covenant Health has restricted the availability of some HAMs as a risk reduction strategy and to meet requirements set by Accreditation Canada.An exception for these restricted products is called a Required Organizational Practice Exception (ROPE). These are made when it is necessary for a restricted product to be available in a selected patient care area. 

If an ROPE is approved for a restricted HAM, specific safeguards must be put in place to minimize errors and risk.   

A ROPE Request Form must be submitted to the Medication Management Safety Team for processing. To obtain this form click here:

Required Organizational Practice Exceptions Request Process

Required Organizational Practice Exceptions Request form


Covenant Health Required Organizational Practice Exceptions:

Concentrated Electrolytes Heparin Narcotics


Safety Initiatives: Additional Resources

Good Catch Reporting - a good catch is any medication related event that has the potential to cause or lead to patient harm, which is caught before it leaves the Pharmacy Deptment. The goal of the Good Catch Program is to help identify areas for improvement within the medication distribution system.


Accreditation Canada

Institute for Safe Medication Practices (ISMP)

Institute for Safe Medication Practices (ISMP) - CANADA

Canadian Patient Safety Institute (CPSI)

CPSI Global Patient Safety Alerts

Safer Healthcare Now

Canadian Society of Hospital Pharmacists (CSHP)

Accreditation ROP Handbook 2015

Accreditation Canada Required Organizational Practices – 2014-2017 Survey Cycle

Medication Management Safety Team News and Updates

Questions/Contact Information

RLS - Reporting and Learning System

Good Catch Reporting