Quality assurance program reduces errors

Jeffry Ellis doesn't lie awake at night anymore wondering whether he made an error at the Medicine Shoppe pharmacy where he works in Sandwich, Ill. And his heart doesn't do a back flip into his throat if a patient complains that her medicine looks different. These days, the 30-year veteran has confidence because he's using a quality assurance program backed by state pharmacy associations.

The Pharmacy Quality Commitment (PQC) program is a turnkey continuous quality assurance system designed to improve patient care by reducing medication errors. Originally developed by former Pharmacists Mutual Insurance executive Kenneth Baker and University of Florida professor David Brushwood, PQC was purchased last summer by the National Alliance of State Pharmacy Associations (NASPA), a wholly owned subsidiary of the National Council of State Pharmacy Association Executives.

PQC is a two-part quality assurance program. The Sentinel System includes a practice guidelines manual, implementation guide and tool kit, a CD-ROM, Internet or print training program, best practices training cards, and annual upgrades.

The second component, the Quality Manager, is an on-line, voluntary self-reporting process in which the pharmacy reports errors and near misses on a daily basis. The data and reports are available only to the pharmacy owner and/ or manager, who can use them to evaluate trends, educate their staff, and adjust the work flow to avoid making the same errors over and over. In addition, the data may reveal the day of the week or time of day when the pharmacy is most error-prone.

On a national scale, data from all the participating pharmacies are aggregated. Individual pharmacies can then compare their results with the national data bank and look for ways to improve the trouble spots. Under the newly enacted Patient Safety and Quality Improvement Act of 2005, such data are beyond the reach of plaintiffs' lawyers.

"The reporting system is extremely easy to use," said Harden. "It takes about five minutes a day to fill out the report. We encourage pharmacists to do it whether there are any errors or near misses or not. To say there were no errors is good too. The aggregated national data will help pharmacies see where corrections need to be made. In the final analysis, what we're trying to do is ensure that the quality of patient care improves throughout the pharmacy and medical professions."

Beginning with the 1999 Institute of Medicine report, healthcare and government officials have been on a quality assurance kick that pharmacies cannot ignore. The Medicare Part D drug benefit requires participating pharmacies to have a continuous assurance program and more third-party contracts are tacking on a QA provision for network pharmacies.

When pharmacist Ellis started using the PQC program two years ago, he had to change the way he filled scripts, which was not easy after so many years behind the bench. "You get in a rut, and this changes all that," he said. "Now it has become second nature. It allows you to get as close as you can to 100% error-free. It takes a little longer, but we really don't want to hurt the patient, and it's good business policy because the lower risk of errors for liability purposes alone is great. It also saves time correcting mistakes, and it saves money."

The PQC package costs $300 for the first year. The annual renewal fee is $200. For more information, phone 1-(866) 365-7472 or go to http://www.pqc.net/ on the Web.