Quality Assurance QA Program

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Quality Assurance(QA) Program

• Oregon Board of Pharmacy

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Oregon Board of Pharmacy

• Dedicated to the health, safety and welfare of
  the public
• Believe the pharmacy profession should strive to
  provide the highest quality of care
• Feel pharmacist should want to find ways to
  improve their practice
• Less stress
• Happy customers

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Oregon Administrative Rules

• OAR 855-019-0300(5)(g)
• Implementing a quality assurance plan for the
  pharmacy.
• OAR 855-041-0132
• Quality Assurance
• (1) The pharmacist-in-charge shall establish
  written procedures for ensuring that there is a
  planned and systematic process for the monitoring
  and evaluation of the quality and appropriateness
  of pharmacy services and for identifying and
  resolving problems. Such monitoring and
  evaluation are accomplished through the routine
  collection and periodic assessment of the
  collected information.
• (2) The findings from and conclusions of
  monitoring, evaluation, and problem solving
  activities are documented and are made available
  for Board inspection.

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Concepts of QA

• Meeting and/or exceeding the needs and
  expectations of our customers
• Most problems are found in processes, not in
  people. QA does not seek to blame, but rather to
  improve processes
• Achieve continual improvement through small,
  incremental changes
• Continuous improvement is most effective when it
  becomes a natural part of the way everyday work
  is done

Continuous Quality Improvement. Iowa State
University. 2009. www.fpm.iastate.edu/worldclass/
cqi.asp accessed 3/16/09
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Steps in QA

• Entire pharmacy team has knowledge of the system
  needing improvement
• Identify and define measures of success
• Brainstorm potential strategies for producing
  improvement
• Monitor and gather data of improvement outcomes
• Analyze results to show that improvements have
  been made and goals achieved

Continuous Quality Improvement. Iowa State
University. 2009. www.fpm.iastate.edu/worldclass/
cqi.asp accessed 3/16/09
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QA Resources

• NABP
• Task Force on Continuous Quality Improvement
• Other states QA/CQI programs
• Quality Care Pharmacy Program of Australia

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Requirements

• Describe quality assurance measures done at each
  step in the prescription workflow
• Document quality-related events
• Quarterly analysis of event/workflow breakdowns
• New workflow established to prevent event in the
  future
• Monitor one or two quality assurance measures
• Set goals to show success of quality assurance
  measure

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Describe QA workflow

• Delivery of medication to the patient
• Ask pt for first and last names and compare to
  the name on the label that is affixed to the
  prescription and receipt. Ask pt an open-ended
  question such as, Could you please verify your
  date of birth?
• If the prescription is new or requires
  counseling, the pharmacist must be notified prior
  to selling

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Quality-Related Events
Names are not required for documentation,
only details of event and workflow breakdown

• Incorrect drug
• Incorrect drug strength
• Incorrect patient
• Inadequate or incorrect packaging, labeling, or
  directions
• Over- or under-utilization
• Therapeutic duplication
• Drug-disease CI
• Drug-drug interactions
• Incorrect drug dosage or duration of drug
  treatment
• Drug-allergy interactions
• Clinical abuse/misuse

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QA Monitoring

• Pulling product
• Track incorrect products pulled by counting bad
  barcode scans
• Goal lt1 bad scans/week
• Data entry
• Track number of data entry mistakes sent back by
  counting technician
• Goal lt1 of prescriptions sent back

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Tips for Success

• Monitoring can be delegated to certified pharmacy
  technicians as long as results, analysis, and
  progress is overseen by a pharmacist
• Program and forms can be tailored to individual
  settings
• Documentation is important to show continual
  progress and improvement
• Inspectors will not be scrutinizing results, just
  looking to see that QA program is in place

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Questions?