An Analysis of Quality Improvement Education at US Colleges of Pharmacy

By Cooley, Janet; Stolpe, Samuel F. et al. | American Journal of Pharmaceutical Education, April 2017 | Go to article overview

An Analysis of Quality Improvement Education at US Colleges of Pharmacy


Cooley, Janet, Stolpe, Samuel F., Montoya, Amber, Walsh, Angela, Hincapie, Ana L., Arya, Vibhuti, Nelson, Melissa L., Warholak, Terri, American Journal of Pharmaceutical Education


Objective. Analyze quality improvement (QI) education across US pharmacy programs.

Methods. This was a two stage cross-sectional study that inspected each accredited school website for published QI curriculum or related content, and e-mailed a questionnaire to each school asking about QI curriculum or content. T-test and chi square were used for analysis with an alpha a priori set at .05.

Results. Sixty responses (47% response rate) revealed the least-covered QI topics: quality dashboards /sentinel systems (30%); six-sigma or other QI methodologies (45%); safety and quality measures (57%); Medicare Star measures and payment incentives (58%); and how to implement changes to improve quality (60%). More private institutions covered Adverse Drug Events than public institutions and required a dedicated QI class; however, required QI projects were more often reported by public institutions.

Conclusion. Despite the need for pharmacists to understand QI, it is not covered well in school curricula.

Keywords: quality improvement, quality measurement, quality control, safety, medication error reduction

INTRODUCTION

Quality improvement (QI), as defined by the Health Resources and Services Administration (HRSA), "consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups."(1) The Institute of Medicine has indicated that each health care team member should be well versed in QI so that the quality and safety of care can be continuously improved. (2)

Advancing quality improvement concepts in pharmacy education has been a focus of the Accreditation Council for Pharmacy Education (ACPE) in recent years for all doctor of pharmacy (PharmD) programs across the United States (US). (3) The American Association of Colleges of Pharmacy (AACP) and The Center for the Advancement of Pharmaceutical Education (CAPE) also formally endorse QI as one of their educational outcomes. (4)

The extent of QI education may vary among the PharmD programs, but there is no denying its importance and impact on a pharmacist's career. Pharmacists and other health care professionals can expect increasing levels of accountability for performance on health care quality metrics in today's health care environment. (5) In fact, the ACPE standards state that "application of... quality metrics to advance patient care and service delivery within and between various practice settings" should be included as part of the required elements for didactic education in PharmD programs. (4) Encouraging education in quality improvement begins with demonstrating its significance and relevance within a pharmacy student's education and career.

The increased relevance of health care quality in the marketplace and pharmacy practice can be used to demonstrate its applicability and importance to pharmacy students. A 2004 study by Jackson shared self-reported data demonstrating that the application of QI concepts in PharmD programs improved students' ability to identify errors, implement methods to decrease errors in their practice setting, and raise awareness of the impact these errors can have on the health of a patient. (6) A study by Gilligan and colleagues assessed both instructors' and students' perceptions of implementing QI education in the curriculum. (7) In this study, five colleges of pharmacy that utilized some portion of the EPIQ ("Educating Pharmacy Students and Pharmacists to Improve Quality" now called "Educating Pharmacists in Quality"; Alexandria, Virginia) educational program demonstrated a statistically significant improvement in students' self-reported QI knowledge. The EPIQ program is a possible model that other colleges of pharmacy may adopt to improve both student QI knowledge and attitudes. (7-10) The EPIQ training program and additional resources are available through the Pharmacy Quality Alliance (PQA) website. …

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