Objective. Literature review and subsequent gap analysis of the current Alberta Cancer Board (ACB) Oncology Medication Error Prevention Status Survey and the incorporation of new information to aid in the development of a stronger medication error prevention system. Design. Gap analysis based on a literature review was performed on the current ACB survey via a literature search of EMBASE, Medline, and the Cochrane Database of Systematic Reviews. The completed survey was sent to 17 ACB sites for feedback. Setting. The ACB in the Canadian province of Alberta, which includes 2 public tertiary centers and 15 associated community satellite sites based around the province in existing hospitals. Main outcome measures. Gaps in the current medication error prevention survey requiring improvement as compared to current literature, with emphasis on pharmacy. Results. All sections required additional information and two new sections were created to reduce the gaps in organizational commitment and environmental concerns. Of the 17 ACB sites, 13 sites responded to the survey and 11 responded to the questionnaire. Out of a possible 154 questions, 64 questions had at least one site disagree and 20 questions had more than one site disagree. Conclusion. Through a literature review and gap analysis, the current ACB Oncology Medication Error Prevention Status Survey was improved. Responses to changes have not only demonstrated the need for a survey of this kind, but also the need for periodic updates of the information in the survey.