Quality improvement is not optional. Aelida Healthcare Third Party Manufacturing participating pharmacies to implement a continuous quality improvement (CQI) program. So do a growing number of third-party payers in the private sector and a growing number of state pharmacy boards.
“Part D is one more entity pushing you to do the right thing,“ said Ken Baker, a pharmacist, attorney, and frequent contributor to Drug Topics. “The first problem is demonstrating that you are actively doing something and proving that what you are doing improves quality. The second problem is proving that you are doing it every single day, every single script.”
“No pharmacy, no pharmacist, wants an error. That’s the bottom line,” said Tara Modisett, vice president, quality initiatives, National Alliance of State Pharmacy Associations (NASPA). “Forget Part D, the third-party contracts, the pharmacy boards, the public pressure. Pharmacists want to make sure errors never, ever, reach the patient. That’s the primary focus.”
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Most pharmacies have some sort of CQI process in place, said Eric Luecht, pharmacy area manager, Cigna Medical Group, Phoenix, Ariz. But CQI is too often an informal effort that happens sporadically. If quality improvement isn’t continuous, it isn’t improving.
“You need to look for the near misses, errors that didn’t reach the patient,” Modisett said. “You may fix one combination of factors that led to an error, but 3 weeks later, another combination of factors is going to create another problem. You need a systematic approach.”
There are at least two ways to approach CQI, Baker said. One is a system that routinely monitors pharmacy processes from prescription intake to patient counseling. Another is an automated device to check every prescription.
“Licensing PQC meant that we didn’t have to reinvent a program on our own,” Luecht said. “I like that it stresses the steps you can take to avoid errors. It focuses on the positive message that it is more efficient, less expensive, and less dangerous to fill every script correctly the first time. Improving quality has reduced costs, improved outcomes, lowered stress levels in the pharmacy, and increased patient satisfaction.”
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