Improving Pharmacy Quality: On-Site Performance Measures
Hesselgrave, Barbara, Drug Topics
In late September, presenters at the annual meeting of the Agency for Healthcare Research and Quality (AHRQ) reported their phase 1 evaluation findings for the Pharmacy Quality Alliance (PQA) medication-use demonstration project.
In 2006, start-up funding from the Centers for Medicare and Medicaid Services (CMS) launched the PQA with a mission to "improve the quality of medication use across healthcare settings through a collaborative process in which key stakeholders agree on a strategy for measuring and reporting performance information related to medications."
The current demonstration project is the steppingstone to development of a plan for future implementation of pharmacy reporting processes. These quality reports will help patients, pharmacists, and providers achieve better medication adherence, safety, and quality, as well as greater patient satisfaction.
Testing the on-site feasibility of pharmacy reporting was the task of the AHRQ-funded evaluation team from the Center for Naval Analyses (CNA), an Alexandria-based not-for-profit research and analysis organization, and its subcontractor, Thomas Jefferson University of Philadelphia. Five demonstration sites across the United States were chosen to test 1 5 pharmacy quality measures, with a goal of involving 100 pharmacists from each demonstration site.
According to Joyce S. McMahon, PhD, CNA's research director, "Defining pharmacy quality is a challenge; this is a complex area not well studied." Much of it, she said, "depends on what the patient does," in terms of behaviors related to filling and taking medications.
McMahon said the Phase I report of the demonstration project assessed the approach and challenges of the performance measures at the 5 sites using 3 models. Model 1 consisted of a health plan partnered with a community pharmacy corporation and education provider; Model 2 consisted of university-led coalitions of plans, pharmacy organizations, and community pharmacies; and Model 3 consisted of a community pharmacy corporation partnered with a medication therapy management services company. Evaluation data were gathered from all sites and included on-site interviews with the project teams, a survey of pharmacists receiving the quality reports, claims data extracts, and data from a pharmacy consumer survey that was conducted as part of the project. …