Magazine article Drug Topics

California Launches Pharmacy Quality Assurance Program

Magazine article Drug Topics

California Launches Pharmacy Quality Assurance Program

Article excerpt


California pharmacists shouldn't worry about the state's new mandatory quality assurance program-not yet. Pharmacy board inspectors will be focusing on education, not enforcement, through mid-2002.

"Until July or August, our role will be primarily educational," state board of pharmacy supervising inspector Robert Ratcliff told R.Ph.s attending the California Pharmacists Association (CPhA) annual meeting in February. "Our goal is to give a compliance meeting and nobody comes."

Pharmacists statewide have expressed concern that board inspectors would begin enforcing the new program when it took effect in January. Under a law passed in 2000, every pharmacy in California must establish a formal quality assurance program to track, report, and reduce medication errors.

"Quality costs, but poor quality costs even more," board member Stan Goldenberg told a standingroom-only audience at the CPhA meeting. "If you put a rock in a bottle, patients will swallow it. Prevention is the key to reducing errors."

California's QA program is one of the most ambitious medication error reduction efforts in the nation, said CPhA general counsel John Cronin. Every pharmacy, inpatient and outpatient, must have written policies and procedures to deal with medication errors. The policies and procedures must be readily accessible to pharmacy employees.

If an error is found, it must immediately be reported to both the prescriber and to the patient. The pharmacist must also suggest ways to avoid or mitigate any potential harm that could result from the error. Every error must be investigated within 48 hours of discovery, Cronin continued, and every investigation must produce a formal report. QA reports must be kept in the pharmacy for at least 12 months.

The report must review the participants who contributed or may have contributed to the error, the circumstances, and all pertinent data and documentation. QA reports must also include formal findings of the review process and recommend changes to prevent a similar error from occurring in the future. All pharmacy personnel must be notified of changes resulting from the review

"You have to investigate, review, and act," Cronin said. "The upside is that your compliance with QA requirements is a mitigating factor in any board investigation of the error."

Goldenberg explained that the goal is to reduce errors, not to punish the pharmacists who make them. "We need a method to learn from our mistakes so we don't repeat them," he said. "Prevention is the key to safety, and data are the key to prevention. …

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