Today, nearly every industry, from hotel management to auto manufacturing, is focused on improvement of quality. Healthcare is no exception. Health regulators, as well as consumers, employers, and third-party payers are seeking increased levels of accountability in health care delivery, and standards of performance are becoming commonplace.
Why this interest in quality assurance and accountability?First, deficiencies in our healthcare system have become increasingly apparent, and have stimulated reform efforts at the national, state, and local levels. Second, rapidly escalating healthcare costs over the past decade have fostered the belief that consumers and payers are not getting their money's worth. Third, pressures to contain costs carry with them concomitant pressures to ensure that existing levels of quality are not eroded.Brook has noted these problems and challenges for the profession of medicine. 1 Pharmacy is very much affected. While pharmacy has always had performance standards, Dale B. Christensen Peter M. Penna 2.0). CONCLUSION: The next few years will witness much experimentation in QA processes and exciting new opportunities for pharmacists as more active participants in patient care. J Managed Care Pharm 1995; 1 :40-51. ;over the past decade or so these have become increasingly specific and detailed. It is possible now to delineate quite precisely the concept of quality, the process of quality assurance, and methods of quality assessment as they relate to the delivery of pharmaceutical services.
WHAT IS MEANT BY QUALITY?Difficult to define but universally understood, quality implies value, worth, and degree of excellence. In general, healthcare quality has been defined in these terms: T What a system of care should deliver T What a healthcare professional or service unit should provide
T What patients expect from providers of care T What patient outcomes should be expectedConsider the quality of care received by Americans, often characterized as the best in the world. To an individual receiving care this may well be true, but, to those denied ac-A bird analogy is often used to describe this relationship. Measures of structure for a bird are feathers per square inch of skin as well as the surface area of each feather. A process measure is wing flaps per minute, and, finally, outcome is whether the bird can fly. For a pharmacist, a structural measure is whether he or she has a degree from an accredited university, the nature of the degree (B.S. or PharmD.), and his or her licensure status. A process measure is whether the pharmacist can appropriately review a patient drug profile, dispense prescriptions, and counsel patients. An outcome measure is whether patients received intended drug therapy. Another is whether the patient appropriately consumed the prescribed drug and was cured of the condition being treated. Each of these examples illustrates two points. First, structure, process, and outcome measures are (or should be) linked. The only important structure and process measures are those reasona...
