Ensuring Quality and Evaluating Outcomes of Value Added Pharmacy Services Flashcards
structures
raw materials needed for production
What are examples of structure?
Raw materials needed for production
- amount of pharmacists
- pharmacists with special training
- pharmacy area (sq ft, counseling area)
- medications (storage / inventory)
What are processes?
- Any phase of the medication use process
- Prescribe → Dispense/Counsel → Administer → Monitor
- Adherence to clinical guidelines or pathways
- Percent of scripts dispensed error-free
- Percent of patients counseled
What are outcomes?
- End result
- Driving force behind
What are the types of outcomes?
- Economic, clinical, humanistic outcomes (ECHO)
- E: Decrease use of health care resources
- C: Increase patients’ control of medical conditions
- H: Increase patients’ satisfaction with care
CQI Cycle: Background
- Focus selection
- Focus description
- Focus importance
- Literature review
- Goals
CQI Cycle: Background - Focus selection
- Brainstorm, rank, consensus
- Failure mode and effects analysis (prospective)
- Root cause analysis (retrospective)
CQI Cycle: Background - Focus description
- Setting
- Portion of medication use process affected
- Baseline data
- Flowcharts
CQI Cycle: Background - Focus importance
- Why is it important?
* How will improvement impact organization?
CQI Cycle: Background - Literature review
What is known and not known about similar situations?
CQI Cycle: Methods
- Intervention
- Process and outcomes measured
- Data collection procedures • Data analysis plan
CQI Cycle: Results
- Analyze data
* Seek statistical assistance
What are the types of economic evaluations?
- Cost-minimization
- Cost-benefit
- Cost-effectiveness
- Cost-utility
Economic Outcomes: Costs
- The value of the resources consumed by a program or treatment alternative
- Direct costs
- Indirect costs
- Intangible costs
Direct costs
- The resources consumed in the prevention, detection, or treatment of a disease or illness
- Direct medical costs
- Direct non-medical costs
Indirect costs
- Missing work (absenteeism)
* Decreased productivity despite presence at work (presenteeism)
Intangible costs
Nonfinancial outcomes, such as pain, suffering, and grief
Cost-Benefit Analysis
- Outcomes can be expressed in monetary terms
- Numerator = program outcomes
- Denominator = program costs
- Benefits / cost
Cost-Effectiveness Analysis
- Treatment alternatives are not therapeutically equivalent
- Outcomes cannot be expressed in monetary units
- Examples of Cost-Effectiveness Analysis: cases cured, lives saved, mm Hg drop in BP
Cost-Utility Analysis
- Quality of life is the most important outcome being examined
- Numerator = quality of life score
- Denominator = direct and indirect costs of an intervention
Clinical Outcomes
- Most obvious variable to health care professionals
- Medications
- Lab values
- Adverse effects from disease or medications
- Use of other health care providers or services
Humanistic Outcomes
- Sometimes called patient-reported outcomes (PRO)
- Health-related quality of life (HRQOL)
- Patient satisfaction
- Illness severity
Humanistic Outcomes: Health-related quality of life (HRQOL)
Multi-dimensional measure of a person’s total well-being including physical, functional, social, and emotional
Humanistic Outcomes: Patient satisfaction
- Extent to which individuals’ needs, wants, and expectations are met
- Satisfaction with Pharmacy Services Questionnaire
