QUALITY ASSURANCE OF CLINICAL PHARMACY SERVICES,Clinical pharmacy services

1. .

2. PROTOCOL
 Definition
 Quality assurance services.
 Assessment of the services.
 Audit and it types and cycle.
 Evaluation of patient counselling.
 Quality assurance in DI services
 Evaluation methods & monitoring.

3. DEFINITION
 Quality assurance is a management technique used to
ensure the quality of practice and its outcome.

4. Quality Assurance Services(QA)
PATIENT COUNSELLING
ADR reporting
Ward round participation
Drug information services
Patient interview
Case note review
Medication chart review
Therapeutic consultation
Drug interactions
pharmacoeconomics
Poison management
News letter
initiation & conducting
pharmaceutical research &
development
Hospital formulary
Dosage adjustment
calculations
Therapeutic drug monitoring
Therapeutic guideline
preparation.

5. Contd…….
 Assuring the quality through ‘customers’ who may be
Patients
Carers
Clients or
Other health care professionals.

6. ASSESSMENT OF THE SERVICES
 Performance appraisal.
 Peer review.
 Professional audit and clinical audit.

7. AUDIT
Clinical audit-multidisciplinary in nature.
It involves receiving the service and discover
deficiencies.
Types of audit:
o Self audit. eg: community pharmacist.
o Peer or group audit. eg: pharmacist from one hospital
look at the services provided from other hospital.
o External audit.

8. WHAT IS MEASURED IN AUDIT?
 3 aspects are audited:
 Structures or resources involved.
eg:staff,their experience and knowledge,books,training
courses,drug stock,equipment and lay out premises.
 The processes used. eg: prescribing policies,disease
management protocols.
 The outcome of the activity. eg: change in health
status,attitude or behaviour of the patient ,also change in
BP ,serum biochemistry etc.

9. AUDIT CYCLE
 Continuous process -involves a cycle of measurement,evaluation&improvement.
desire for improvement (or)
evidence of poor quality service.
set or improve standards
identify problems observe practice
And implement changes
compare practice
to standard

10. EVALUATION OF PATIENT
COUNSELLING
 It divides into:
Introduction items
Content items
Process items
Conclusion items

11. POINTS TO EVALUATE
COUNSELLING.
 Conduct Self introduction and patient or patient’s
agent.
 Explain the purpose of counselling.
 Make apppropriate use of patient profile information
 Assess the patient understanding of the reasons for
therapy.
 Respond with empathic response.
 Use languages that the patient can understand.

12. Contd…..
 Display effective non-verbal behaviour.
 Maintain control and direction of counselling session.
 Use open ended questions
 Present facts and concepts in logical order.
 Provide complete information to the patient.eg
indications,dosage regimen,etc.
 Provide complete information.
 Verify understanding through feedback.
 Summarize using key points.

13. Quality assurance in DI services
To evaluate every aspect of practice and to improve
existing services.
Assessment techniques:
I. Work load statistics
II. Auditing
III. Enquirer’s assessment
IV. Peer review

14. Evaluation methods & monitoring
Input level
Processes level
Output levels

15. Input levels
Staff
Resources
Organization

16. Processes level
Receiving queries
Search strategy
Data collection
Literature evaluation
Formulation & communication of reply
Documentation & storage

17. Output levels
User satisfaction
Patient outcome
DI publication
Problem identification
Corrective actions
effectiveness of correction
Communication of results

18. References
 Pharmaceutical practice edited by A.J.Winfield,R.M.E.
Richards 2nd edition pg no:332,351,462,463.
 Remington: the science and practice of pharmacy 21st
edition vol. 1.