1. INSTITUTIONAL PHARMACY PRACTICE STANDARDS

2. Quality assurance (QA) Criterion Standards
Terms closely associated with standards of practice:
Quality
Quality assurance (QA)
Criterion
Standards
“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 decide
What is to be done
Measuring how well the job was done
If no acceptable results, undertaken corrective actions to ensure that in future they will be acceptable
The 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 or
acceptable or average practice.

5. QUALITY ASSESSMENT
Assessment efforts are based on three categories:
structure
process
outcome

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 standards
Increase accountability of the profession to the public by articulating, supporting and protecting the rights of patients
Sources of standards for pharmacy practice
Law, regulations, and rules issued by government
Standards developed by accrediting bodies
Standards developed by professional organization.

8. Legal Standards
Readily 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.
Accreditation
Accreditation is acknowledgement that an institution or program has met predetermined standards of quality
(JCAHO): Joint Commission on Accreditation of Healthcare Organization
MRQP: 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 Assurance
The 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 improvement
action
resolve the problems
or bring
performance 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 criteria
Gather data
Identify departures
Take the action directed by the medical staff.

12. Agenda for Change
The need for evaluation systems that look beyond what care is given and how it is rendered, to evaluate the patient’s health status
The outcome measurement was favoured more than the structure and process evaluation
This approach is better by
Ensuring value for health car money spent
Controlling the individual components of care
Increasing the likelihood that commonly accepted performance standards are used.

13. Pharmacy Organizations
Indicators
Providers of care monitor their own performance and services.
Pharmacy Organizations
One of their prime functions is to establish and implement standards of practice.
Why
To hold members accountable for using standard
To protect the public from individuals who have not attained or follow the standards
To protect individual members of the profession from each other
To maintain and improve standards.

14. Several pharmacy organizations have been involved in developing standards of practice
ASHP practice standards consist of:
The statements
Guidelines
Residency accreditation regulations
Technical 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 in
Recruitment
Orientation and training
Performance planning and review
Describing 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 responsibilities
Engineered standard: based on the result the organization needs
Historical standard: based on the previous results
Comparative standard: based on the results that others are achieving

17. Future Direction
Improving 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.