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Background: Medical errors is the first (24.8%) rank of the 10 reported incidents as a result of high prescription frequency in health care. Lean and Safety Project (L&S Project), a combination of Health Lean Management and Clinical Risk Management, is one of the promising tools to improve safety. Objective: This study aimed at identifying the problem of medication error and proposing improvement through L&S Project. Methods: The study was performed in a class B teaching hospital with 410 beds. We implement the five steps of L&S project in Pharmacy unit. The five steps are determination of triggers and objectives, organizational aspects, phases, outcomes and sustainability, enabels and obstacels. Results: The main problem found in medication errors is the rate of drug administration error by 6%. The results of the L&S Project approach are produced a special pharmaceutical safety guidance system consist of policies, standards operating procedures, and service flowchart. We proposed a new steps with the seven safety in clinical pharmacy, which are safe prescription data, patient bill category, 7 right medication, drug label, dispensing, distribution, and information. Conclusion: Identification of the main problem is drug administration error. Proposed improvement carried out through L&S Project with seven safety in clinical pharmacy.