As you will be aware, there has been an increased focus on quality in pharmacy in recent years and particularly on having an effective quality management system (QMS) in place. This helps ensure the safe delivery of pharmacy services at a standard that meets patients’ needs and expectations. A robust QMS not only benefits patients by ensuring a consistent standard of care but also minimises the chances of negative reputational or regulatory consequences for pharmacists.
Important Elements of Quality Management Systems:
The important elements that underpin quality in pharmacy practice include:
- establishing a patient safety and continual improvement culture
- ensuring effective communication
- implementing risk assessment and reduction systems
- implementing effective error and near-miss management systems
- engaging effectively with patients and customers, including managing complaints
- having robust documented policies and procedures in place and ensuring such policies and procedures are implemented and followed
- ensuring adequate staff training occurs
The ongoing monitoring of processes and review of procedures, complaints and errors in order to continually improve patient services is a particularly important part of the process.
How to Achieve Quality Improvement in your Pharmacy:
- Involve and engage with the pharmacy team (to develop a patient safety culture and ensure ‘buy-in’ to change)
- Critically review/ audit the current quality management system, including processes, documents, records and training methods
- Assess risks: Review relevant internal information, e.g. errors and near-misses, patient/ customer complaints, and external information, e.g. HPRA newsletters, PSI Fitness to practice learnings
- Develop an action plan to minimise risks. Establish the priorities for improvement, focusing on the core activities that affect patient care and quick wins first, e.g. management of the dispensing process and patient counselling, with a specific focus on ‘high- tech’ and high-risk medicines
- Utilise support tools, as appropriate throughout the process:
- Regulatory and best practice documents
- Assessment tools: e.g. risk register, SWOT analysis (strengths, weaknesses, threats, opportunities), ‘the five whys’
- Quality improvement tools: e.g. PDCA (plan, do, check, act), CAPA (corrective and preventative actions)
- Set SMART targets (specific, measurable, achievable, realistic and time based) and ensure follow through
- Establish a continuous quality improvement system, with regular ongoing reviews of systems, documentation and training
Further Information on Quality Management Systems:
The importance of robust QMS have been highlighted by the PSI, though its Pharmacy Assessment System and via the inspection process. Their requirements are supported and explained through their guidelines, advisory and fitness to practice learning documents, available on the PSI website (www.psi.ie). Other pharmacy organisations both national and international have also issued useful documents, e.g. several useful documents are available on the RPSGB website (www.rpharms.com).
Online and face to face pharmacy specific quality courses are provided by the Irish Institute of Pharmacy and such courses improve pharmacists’ knowledge and ability in this area. Other quality management system courses, e.g. on ISO QMS, are also available. Engaging with other pharmacists who have implemented quality management systems nationally and internationally and learning from their experience is also helpful.
PharmaConsult provides quality review and improvement services, which assist pharmacists in assessing risks and reviewing their current or implementing a new quality system. This can occur either across the pharmacy or for specific pharmacy services, e.g. management of residential care homes. Bespoke tailored services are available and several standard support services and documents have been developed. Please don’t hesitate to contact us if you would like to discuss these services further (info@pharmaconsult.ie).
Caroline Hogg MPSI, Owner and Lead Consultant PharmaConsult