2 Quality assurance (QA) Criterion Standards Terms closely associated with standards of practice:QualityQuality assurance (QA)CriterionStandards“Quality” is a complex concept of a multidimensional phenomenon.Generally, it is the ability to achieve desirable objectives (achievable state of health) using legitimate means.
3 “Quality assurance” or improvement describes all efforts to measure, assess, ensure, and evaluate health care.Is to decideWhat is to be doneMeasuring how well the job was doneIf no acceptable results, undertaken corrective actions to ensure that in future they will be acceptableThe abstract and judgement formulations of quality must be translated into more objective criteria and standards that can be used as reliable and valid measuring tools
4 “Criterion” is an absolute term of what should be found if quality is optimum “Standard” is flexible term that expresses the degree of acceptable variation from the criterion.The standard and criterion are equivalent:If no deviation is acceptable and the criterion must be met.“Empirically derived criteria and standards ”When obtained:by the observation of good oracceptable or average practice.
5 QUALITY ASSESSMENTAssessment efforts are based on three categories:structureprocessoutcome
6 Structure is the facilities, equipment, services and manpower and their qualification. Process is the activities take place between the patient and the provider.Process measures include: the procedures or steps followed in providing care.Outcome refers to the result of care.Outcome in pharmacy is simply the result of a set of procedures operating within structure.Outcome measures include:biological changes in disease, ability for self-care, physical function, patient satisfaction.
7 It is best to include in any system of assessment elements of structure, process and outcome. Use of Standards:Aspects of the quality of medical care are compared to predetermined standardsIncrease accountability of the profession to the public by articulating, supporting and protecting the rights of patientsSources of standards for pharmacy practiceLaw, regulations, and rules issued by governmentStandards developed by accrediting bodiesStandards developed by professional organization.
8 Legal StandardsReadily identifiable standards have legal significance in the practice of institutional pharmacy.The Saudi government through the laws and regulations of practicing pharmacy is responsible for the implementation and for the control and prevention.AccreditationAccreditation is acknowledgement that an institution or program has met predetermined standards of quality(JCAHO): Joint Commission on Accreditation of Healthcare OrganizationMRQP: Makkah Region Quality Program
9 Accreditation is important for the hospital in many ways: It contains the legal requirements.Most health insurance company pay for care in accredited hospital.Demonstrates to the public that a hospital meets the standards.Provides an opportunity for hospitals to assess the strong and weak features and make improvements.Quality AssuranceThe standards used in a quality assurance program must define a level of patient care that is both optimal and achievable, i.e., standards that are high, yet attainable with available resources.In this program, problems or areas for improvement must be identified first then action must be taken to resolve the problems or bring performance closer to the established standards.
10 performance closer to the established standards problems or areas for improvementactionresolve the problemsor bringperformance closer to the established standards
11 Drug Usage Evaluation (DUE) Drug usage evaluation is a medical staff quality assurance activity, designed to promote appropriate, safe and effective drug use.Pharmacy professional guide the medical staff through the process.Recommend drug use criteriaGather dataIdentify departuresTake the action directed by the medical staff.
12 Agenda for ChangeThe need for evaluation systems that look beyond what care is given and how it is rendered, to evaluate the patient’s health statusThe outcome measurement was favoured more than the structure and process evaluationThis approach is better byEnsuring value for health car money spentControlling the individual components of careIncreasing the likelihood that commonly accepted performance standards are used.
13 Pharmacy Organizations IndicatorsProviders of care monitor their own performance and services.Pharmacy OrganizationsOne of their prime functions is to establish and implement standards of practice.WhyTo hold members accountable for using standardTo protect the public from individuals who have not attained or follow the standardsTo protect individual members of the profession from each otherTo maintain and improve standards.
14 Several pharmacy organizations have been involved in developing standards of practice ASHP practice standards consist of:The statementsGuidelinesResidency accreditation regulationsTechnical assistance bulletins
15 Departmental Standards of Practice Performance Standards Standards are necessary to ensure consistent, comprehensive services for patient.They serve as important management tools inRecruitmentOrientation and trainingPerformance planning and reviewDescribing staff responsibilities.Practice standards should be incorporated into the strategic planning and should be consistent with the philosophy, mission, and goals of the department.
16 Once departmental standards of practice have been developed, audits may be done to determine if the department is compliant.Performance standards must be measurable and challenging, but also they should be realistic and achievable.They can be designed to measure quality, quantity, time or cost associated with the job responsibilitiesEngineered standard: based on the result the organization needsHistorical standard: based on the previous resultsComparative standard: based on the results that others are achieving
17 Future DirectionImproving clinical outcomes for a wide variety of disease entities depends on optimising pharmaceutical care.Pharmacy must play a key role in developing and implementing new ways to measure and validate the effectiveness of drug use.Future standards for care should be oriented to the patients desired.