23 Error Reduction Techniques

Patient safety and the integrity of compounded preparations rely on effective strategies to reduce errors throughout the compounding process. In Canada, pharmacies must follow applicable standards such as NAPRA’s Model Standards for Pharmacy Compounding, along with provincial regulatory requirements. The following error reduction techniques support quality, consistency, and safety in both sterile and non-sterile compounding environments.  Error reduction in pharmacy compounding is critical to ensure the safety, quality, and efficacy of preparations.

1. Standard Operating Procedures (SOPs)

• Develop and follow clear, written SOPs for all compounding processes.
• SOPs should include step-by-step instructions for preparation, labeling, documentation, and cleanup.
• Regularly review and update SOPs to reflect best practices and regulatory requirements.

2. Comprehensive Training and Competency Assessment

• Ensure all compounding personnel receive initial and ongoing training that includes:
  • Theory (e.g., calculations, ingredients, procedures)
  • Practical skill development (e.g., weighing, various mixing techniques)
• Validate competency through written tests, observational assessments, and regular performance evaluations.
• Provide refresher training when new equipment, processes, or regulations are introduced.
• Training records must be maintained and updated as per regulatory requirements.
• There are great training courses through organizations such as PCCA, Medisca, and others.

3. Independent Double-Checks

• Implement independent double-checks at critical steps (e.g., ingredient selection, weighing, final product verification).
• Use a second qualified individual to verify calculations and measurements.
• Double checks help detect human errors before they affect the final product.

4. Environmental controls and clean workspace

• Organized, clean and clutter-free workspaces reduce distractions and improve accuracy.
• Designated compounding areas must be well-lit, properly ventilated, and compliant with NAPRA’s environmental requirements
• Use appropriate lighting, ventilation, and temperature control to support accuracy and safety.
• Minimize non-essential conversations and tasks during compounding.

5. Labeling and Documentation Accuracy

• Immediately label all ingredients, intermediate products, and final compounded preparations.
• Use standardized labels that include drug name, strength, quantity, BUD, storage conditions, and auxiliary warnings.
• Complete compounding records must include:
  • Formula and method
  • Equipment and PPE used
  • Ingredient lot numbers and expiry dates
  • Weights/volumes used
  • Final check sign-off

• Keep batch records, worksheets, and verification logs to enable traceability and audits.

6. Use of Technology and Automation

• Utilize technology where possible to reduce human errors, such as:
  • Electronic compounding systems for calculations
  • Barcode scanning for ingredient verification
  • Automated systems for weighing and mixing.
  • Automated dispensing and labeling systems
• Validate and maintain equipment regularly.

7. Quality Assurance (QA) and Quality Control (QC)

• Regularly perform in-process checks, final inspections, and audits.
• Perform routine verification of equipment calibration and personnel technique.
• Maintain QA documentation to support compliance with regulatory standards and inspections.

8. Incident Reporting and Continuous Improvement

• Establish a non-punitive system for reporting near misses and actual errors and to encourage transparency.
• Conduct root cause analyses to identify trends and contributing factors.
• Share lessons learned with staff and incorporate changes into SOPs or training.

9. Human Factors and Fatigue

• Encourage scheduled breaks and rotating tasks to reduce fatigue.
• Minimize interruptions by designating the compounding area as a “quiet zone.”
• Implement checklists to reduce memory reliance.
• Use buddy systems or double-checks for high-risk compounds.
• Create a culture where it’s acceptable to pause or delay compounding if fatigue or stress is affecting performance.

Effective error reduction in pharmacy compounding is achieved through a combination of preventive systems, professional vigilance, and continuous quality improvement. Compounding teams must prioritize clean environments, follow documented procedures, and engage in open communication to minimize risk. Tools such as double-checks, automation, and routine audits not only detect potential errors but also build confidence in the accuracy and safety of compounded products.

A culture of safety depends on empowering all staff members—regardless of experience—to ask questions, speak up, and take ownership of the compounding process. When pharmacies consistently apply these principles, they create an environment where both staff and patients benefit from safe, effective, and high-quality compounded medications.