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Models for Quality Improvement

Learn more about the models for improving the quality of pharmaceutical services.
Prescription filling technology need to be then assessed and improved.
These are the technology that could be improved day by day according to the prosperous of technology. So, pharmacists should keep currently about the prosperous of these filling technologies. Pharmacists should monitor patients for high risk side effects. So, this is a very important responsibility of pharmacists. And, pharmacists should routinely review patient medication records especially when transitioning between types of care. This is also a terminology called medication reconsideration, which means the patient’s medication should be reviewed whenever the patient has transition from one type of care, for example, the patients was at home and right now admit into the hospital, or from the hospital discharge to the home, or discharge to nursing home. These are the transition of care.
And all the medications need to be reviewed at transition time point. And there are a lot of models of quality improvement. The most common ones are the lists here. For example, total quality management, continuous quality improvement, six-sigma, LEAN, L-E-A-N, these are pretty common models. But all of models share the following principles.
Number one: The status quo is unacceptable. The status quo means current status, the improvement is a continuous process. So, the status today is correct, probably not correct for tomorrow. So, the quality improvement is changing daily, so we need to know the change must occur, and it must be continuous. So, maintain the same status every day is not acceptable. And safety can be enhanced by improving the core process of medication use system. The core processes of medication use system are the essential steps in the medication use system. And after reviewing all the process, we may eliminate duplication, we may avoid unnecessary steps, we may decrease process time, and or we could simplify the overall process.
These are very important possible result after we review the core process. And safety efforts must be patient-centered. For a long time, we used to look at the convenience and the working aspect of healthcare workers. But right now, we should focus the safety efforts on patients. Quality must be measured. If something cannot be measured, then you don’t know whether the quality has been improved or not. So, when we try to identifying problems with core processes, we also require establishing key measures of the process and monitoring them. So unless quality is measured, it is not a priority, and there will be no way to identify whether it is improving, worsening, or staying the same.
Lastly, solutions to safety problems should address the system, not individuals. This means system is the major focus when we try to solve the problems. Instead, we don’t finger point to the individuals that commit the errors. Usually, we change the system. And then, the individuals could stop committing the errors. A lot of time, poorly designed system set up individuals to fail. So, we need to focus on the system, especially those steps that cross organizational and professional line. Because these are usually the gap occurs between the different professions through same medication use process system. Finally, we come to the conclusion. Medication safety is a fundamental responsibility of all pharmacists.
And the complexity of the medication use process requires pharmacists to have knowledge about types of safety problems, the cause of errors and drug-related morbidity, and practice can reduce them. So, when we know there are different or there are many methodologies to improve the medication errors, we could use technology. But, technology is not the only answer. We also need to focus on the personal training and also improving the workflow, and good leadership is also very important. So, these are all essential solutions to medication safety.

In this article, Chiang explains the models we can apply to improve medication safety.

Quality Improvement Models in Pharmaceutical Services

Additional recommendations for pharmacists to reduce medication errors:

  • Optimize prescription filling technology
  • Monitor high-risk patients
  • Medication reconsideration

Common models of quality improvement include total quality management, continuous quality improvement, six-sigma, LEAN, L-E-A-N.

They vary slightly but follows the same principles:

  • Constant continuous improvement
  • Streamline overall medication use system
  • Safety efforts should be patient-centered
  • Always measure and record the outcome
  • Solutions should address the system and not individuals

To learn more about these quality models, check out this course- Good Pharmacy Practice: Pharmaceutical Services from Taipei Medical University

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Good Pharmacy Practice: Pharmaceutical Services

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