DEVELOPING THE PRINCIPLES FOR SYSTEM-FOCUSED QUALITY INDICATORS FOR PHARMACY
How do we define quality in pharmacy? How do we measure pharmacy’s impact on patient outcomes?
And how do we all – the regulator, government, pharmacy professionals and other stakeholders – monitor pharmacy’s impact on health system performance, make evidence-informed improvements and demonstrate the value of our collective work to patients?
This past year, the College and Health Quality Ontario (HQO), the provincial advisor on health care quality, came together to set the stage for the development of a set of standardized and system-focused indicators for pharmacy. Establishing these indicators will help answer important questions related to the quality of pharmacy practice and its impact on patient outcomes and the overall quality of our health system in the province.
The first step? Listening and learning.
DIVERSITY OF INSIGHTS KEY TO SUCCESS
Pharmacy professionals, like other healthcare professionals, play an active part in providing quality and safe care to patients while contributing to solutions to address common quality challenges experienced throughout our health system. Safe transitions of care, the opioid crisis, medication-related adverse events and antimicrobial resistance are just a few examples where pharmacy can play an increasingly valuable role in our health system, while continuing to contribute directly to a patient’s health goals. However, at this time there is no way to measure pharmacy’s impact on these issues.
With the goal of closing this gap, the College and HQO recently brought together a group of key stakeholders to achieve consensus on a set of principles that will guide the development of standardized and system-focused pharmacy quality indicators. .
The Quality Roundtable: Pharmacy Indicators session held in June 2018 at the University of Toronto included patients, providers (including pharmacists), experts in data and informatics, and stakeholders from the Ministry of Health and Long-Term Care, Local Health Integration Networks, insurance providers, associations and academia. The diversity of insights was important as it provided an opportunity for participants to consider the perspectives of pharmacy professionals and patients and to learn from the experiences of other parts of the health care system where indicators are already firmly established.
Facilitated by Dr. Adalsteinn Brown, the Dean of the Dalla Lana School of Public Health and the Dalla Lana Chair of Public Health Policy at the University of Toronto, session participants discussed areas they considered important to measure from the patient, provider and system perspectives. Some of these included indicator measurement areas related to patient experiences and outcomes, provider experiences, appropriateness of medications dispensed, medication related incidents and hospital visits, and transitions of care.
In addition to identifying indicator measurement areas, session participants also discussed principles to consider when moving forward with a quality-based approach to reporting. These included ensuring an adequate focus on high-quality data access and infrastructure support, analysis and sharing of indicator data, developing capacity for quality improvement in pharmacy practice and open sharing of system-wide indicators.
So why is this important to pharmacy and pharmacy professionals, and why now?
Developing system-focused pharmacy indicators will not only help establish pharmacy within the province’s quality health care agenda, it will promote a better understanding of the performance and impact of pharmacy on patient outcomes and on broader health system quality priorities and challenges. The adoption of a common set of indicators will lead to better data on which to make evidence-informed decisions to guide improvements in areas such as clinical practice, care models or standards and to help identify solutions that ultimately promote high-quality and safe patient care for all Ontarians.
The Roundtable was the first of several steps in the journey to establishing standardized pharmacy indicators. A synopsis document, which summarizes the discussion and takeaway messages from the Roundtable, is expected to be published and posted on the College website in September 2018.
A synopsis will support the College’s ongoing work with HQO and an expert panel and will eventually lead to the development of a formal set of province-wide quality pharmacy indicators that will be shared for open consultation with members and the general public.