Preventing medication errors requires efficient and effective methods to detect them. From incident reporting (IR) systems to trigger tools to MEDMARX, limitations in whether these systems provide a true representation of the problem remain. This systematic review compared different detection methods and found that direct observation captured the greatest number of drug-related problems while IR systems generated the least. However, IR systems demonstrated a higher specificity for severe problems and were generally the least expensive. Trigger tools were the least labor-intensive and most sensitive strategy. The authors conclude that the various detection strategies all have strengths and limitations; however, they seem to capture different drug-related problems, which suggests the need for more than one lens for medication safety detection.