New principles to improve the quality of pharmacy services

PSA’s recently released clinical governance principles are a blueprint for the design and implementation of safe and high-quality pharmacy services.

The Clinical Governance Principles for Pharmacy Services 2018 document provides pharmacists and organisations involved in the provision of pharmacy services the guidance to improve safety, quality and consistency of new and existing services in healthcare delivery.

The principles build on the work undertaken by the Australian Commission for Safety and Quality in Health Care.

PSA National President Dr Chris Freeman spoke to the importance of clinical governance as a key mechanism to reduce medicine-related harm, and encouraged pharmacists to embrace the guidelines so that they can provide the ‘best possible care to patients’.

‘We have a high-quality health system in Australia, and a high-quality pharmacy profession providing valued care to their communities and patients, but there are still unacceptable variations in health outcomes,’ he said.

The high cost of medicine misadventure was highlighted in PSA’s Medicine Safety:Take Care report, which found that 250,000 people are admitted to hospital each year due to medicine-related problems, at a cost of $1.4 billion.

‘Pharmacists are the key to improving the safe and quality use of medicines but, while all pharmacy services have a degree of quality management and governance, the formal application of clinical governance varies considerably, Dr Freeman said.

‘These principles will help guide service design which provides reassurance as to the safety and quality of the services pharmacists provide and can be applied by pharmacists in all settings, whether in community or hospital pharmacy, general practice or aged care.

‘All the principles described in the document are essential to safe and effective care. The principles are not auditable accreditation criteria, but can be used to help identify safety and quality gaps when designing, monitoring and evaluating pharmacy services.’

Dr Freeman said that the principles will also shape high-quality pharmacist services into the future, which will be funded by the 7th Community Pharmacy Agreement.

The principles in brief

PSA’s Clinical Governance Principles were developed in accordance with the components of the National Clinical Governance Framework and tailored to ensure the provision of safe and effective pharmacy care.

The five principles include:

Partnering with consumers. This means actively engaging consumers in the design of the services and care that they receive. It is important to maintain a patient-centric approach where services are delivered to consumers based on their health needs and preferences. Consumers should also be empowered to participate in informed decisions made about their care through the improvement of their health literacy. Consumer experience should be measured through feedback to ensure the continual development and improvement of quality care.

Governance, leadership and culture. This entails the commitment to a culture of safety and quality by developing pharmacy services through adequate resources, systems and evidence. The responsibility for the safety and quality of these services should be shared between pharmacists, funding bodies, management and consumers. Clinical leadership should also be championed, and the values of quality and safety embodied in behaviour and decisions – along with continued monitoring and reviewing to ensure standards are met.

Clinical performance and effectiveness. Services should be developed according to professional guidelines, standards, policies and procedures to allow for the scope and provision of competent pharmacy services. Pharmacists should continue to improve upon their knowledge and skills through education and training, and always use an evidence-basis, indicators, models-of-care and data to inform clinical decisions. Transparency with consumers and stakeholders about the benefits, risks and cost of services is paramount. Effectiveness, quality and safety of pharmacy services should be measured, monitored and reviewed in accordance with clinical measures including audits, research projects and management of pharmacist and staff performance.

Patient safety and quality improvement systems. Risk management systems should include policies and procedures to manage and minimise risk of patient harm, incident management including near misses, and open disclosure. It is important that pharmacists consistently adhere to codes, guidelines and quality systems and commit to continuous quality improvement using an evidence-base to support enhancements in clinical outcomes and patient safety.

Safe environment for delivery of care. Pharmacists should ensure environmental and cultural safety within their practice. The pharmacy environment and equipment should support consumer needs and be an inclusive space that respects the cultural diversity of consumers.

To read the Clinical Governance Principles for Pharmacy Services 2018 in full, click here.

Learn more about improving pharmacy services and how pharmacists can be empowered to fulfil their role as the custodians of medicine safety at the PSA19 conference in Sydney from 26–28 July.