Quality, in pharmacy

Shane R, Gouveia WA. 2000. Developing a strategic plan for quality in pharmacy practice. Am J Health-Syst Pharm 57 470-4. 

List three methods for ensuring quality in pharmacy practice. 

So what is quality in pharmacy practice Extrapolating from the preceding discussion, it can be said that quality in pharmacy practice... 

Each of the preceding (i.e., structure, process, and outcomes) has been used to measure quality. Traditionally, quality in pharmacy practice has been measured by structure and process methods. This relies on a premise that a quality outcome is not possible without appropriate structure or process. Moreover, it is much simpler and less controversial to measure structure and process than it is to measure outcomes. Recently, however, outcomes quality measurement has become more prevalent. 

In a recent seminar, a medical expert noted that the United States has given away economic and technical dominance in industry after industry to other countries. Healthcare research is one of the few areas in which the U.S. enjoys unparalleled leadership which has enormous impact on the quality of medical care. If the healthcare industry and the academic medical enterprise falters—and this is in danger right now—I think it will be an absolute disaster for this country [40]. Many in pharmacy, medicine, and other healthcare fields would concur with the above statement. The problem is that many others in the public sector do not fully appreciate what is at stake. Pharmacists have an opportunity to help tell the story, as difficult as it sometimes is to convey. 

Justify the use of successful quality practices employed by other industries in pharmacy practice. 

Clinical outcomes measures can include morbidity and mortality, event rates, and symptom resolution (Ovretveit, 2001). These measures are a direct measure of quality but may be difficult to assess, especially in pharmacy, where their onset could be years following a treatment or intervention (Chassin and Galvin, 1998 Shane and Gouveia, 2000). In these cases, indicators or markers can be used to assess outcomes. These indicators can be condition-specific (e.g., HgAlc) or procedure-specific (e.g., rate of postoperative infection after hip surgery) or address an important issue of patient care. For example, blood pressure may be used as a marker to assess susceptibility to stroke because it is not practical, safe, or ethical to wait and measure the occurrence of stroke. 

Anita has begun to address quality in her pharmacy practice setting. 

Front-line managers and supervisors often have limited control over both the internal and external environments of health care delivery. However, if job satisfaction, professionalization, and quality service are to continue and improve in pharmacy, there must be an... 

About the Author Dr. Bentley is an Associate Professor in the Department of Pharmacy Administration and Research Associate Professor in the Research Institute of Pharmaceutical Sciences at the University of Mississippi School of Pharmacy. He received a B.S. in pharmacy and an MBA from Drake University and an M.S. and Ph.D. in pharmacy administration from the University of Mississippi. In addition to statistics, Dr. Bentley s teaching interests focus on the organization, delivery, financing, and outcomes of health care. His research interests include understanding the role of pharmacy practice in how medications and the medication consumption experience affect quality of life, the use of quality-of-life measures as clinical tools, and empirical investigations of ethical issues in pharmacy and research. 

Another useful distinction made by service quality researchers is between technical quality and functional quality. Technical quality refers to customer perceptions about what is received from a service (e.g., Was the outcome of the service successful ), and functional quality refers to customer perceptions about how a service was performed (e.g., Did the service provider demonstrate concern and inspire confidence ) (Kotler, 2003). Perceptions of both functional and technical quality are important determinants of service quality, suggesting that service providers need to focus on being high touch as well as high tech. In pharmacy, there is some evidence that functional quality has a greater impact on consumer perceptions of service... 

The last marketing-mix variable is productivity and quality. One issue here is creating efficiency in pharmacy service activities. This means that monitoring and feedback of service encounters should be performed. Then pharmacists can be trained to be efficient in the time spent with patients when providing services. Time benchmarks can be established for various service offerings. Nonpharmacist personnel should be used where appropriate, such as in scheduling appointments and billing payers. 

Based on the descriptions of independent community pharmacy practice and the characteristics of the individuals who pursue this career path, several points must be made. First, independent pharmacists are placed in a difficult situation because of their need to possess expertise in pharmacy practice and business. All pharmacy organizations must stay in business so that they may provide goods, services, and care to patients. Second, independent community pharmacy practice represents one of the most accessible health care venues for patients. Because of this, there exist numerous clinical opportunities for pharmacists in the provision of quality patient care and positive patient outcomes. Third, independent community pharmacists contribute to the overall health of any community not only in the care provided but also in contributions to the economic and civic health of the community. As a health care provider, the pharmacy adds a stable business to any town s economic structure. Additionally, through involvement of the owner and other staff members in civic organizations, these individuals serve as volunteer leaders in activities ranging from school and hospital boards to elected offices. 

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