Hospital Pharmacy Certification: Quality Indicators in Medication Preparation and Distribution Areas
Hospital Pharmacy Certification: Quality Indicators in Medication Preparation and Distribution Areas
The Hospital Pharmacy plays a crucial role in the healthcare context of providing healthcare, being responsible for several activities related to the medicine circuit. In this context, it is important to establish clear guidelines, standardized conduct, and practices, to promote continuous quality improvement.
This study aims to contribute to the development of a certification framework for Hospital Pharmacies, focusing on the identification of quality indicators, used by the accreditation models in Portugal and certifications referentials, in Medication Preparation and Distribution areas.
A qualitative study was conducted, of a cross-sectional and exploratory nature, and a panel of experts was asked to select relevant indicators to measure the quality provided, from 88 indicators identified in literature. Based on the Delphi approach, a first round was conducted, allowing the identification of 65 quality indicators considered relevant by the panel, including structure, process, and result indicators.
The selection of these indicators constitutes an essential step towards the construction of a certification framework aimed at promoting excellence and the work of the multidisciplinary team in Hospital Pharmacies in Portugal.
Certification, Hospital Pharmacy, Medication Preparation and Distribution, Quality Indicators.
Manuela Frija Alexandre has a master’s degree in management and Evaluation in Health Technologies. She is a pharmacy TSTD since 1991 and currently works as a quality manager in a public hospital. Her research interests are in the areas of quality management, health certification and health management.
André Filipe Ferreira Coelho has a PhD in Clinical Research and a Master in Public Health. He’s a Full Professor at Lisbon School of Health Technology and a Consultant for the Portuguese Directorate-General of Health for the area of Patient Safety and Medication Safety
Bezverhni, Z., & Grintsova, O. (2019). Pharmacy professional standards defining quality of services. Encyclopedia of Pharmacy Practice and Clinical Pharmacy, 2011, 174–181. https://doi.org/10.1016/B978-0-12-812735-3.00125-4
Brou, M. H. L., Feio, J. A. L., Mesquita, E., Ribeiro, R. M. P. F., Brito, M. C. M., Cravo, C., & Pinheiro, E. (2005). Manual da Farmácia Hospitalar. Ministério Da Saúde, 69. Retrieved from http://www.infarmed.pt/portal/page/portal/INFARMED/PUBLICACOES/TEMATICOS/MANUAL_FARMACIA_HOSPITALAR/manual.pdf
Canning, M. L., Barras, M., McDougall, R., Yerkovich, S., Coombes, I., Sullivan, C., & Whitfield, K. (2024). Defining quality indicators, pharmaceutical care bundles and outcomes of clinical pharmacy service delivery using a Delphi consensus approach. International Journal of Clinical Pharmacy. https://doi.org/10.1007/s11096-023-01681-y
CHKS. (2020). Programa de Acreditação para Organizações Prestadoras de Cuidados de Saúde. Retrieved from www.chks.co.uk
Decreto-Lei no. 23/2011, Diário da República, 1.a série – N.o 30 – 11 de Fevereiro de 2011 § (2011). Retrieved from https://diariodarepublica.pt/dr/detalhe/decreto-lei/23-2011-279775
DGS. (2014). Programa Nacional de Acreditação em Saúde – Reconhecimento da Qualidade no Serviço Nacional de Saúde (DQS).
DGS. (2023). Manual Standards ME 5 1_08 Unidades de Gestão Clínica (DQS). Retrieved from https://www.sspa.juntadeandalucia.es/agenciadecalidadsanitaria
DQS. (2020). Modelo de Certificação dee Unidades de Saúde do Ministério da Saúde. (DQS, Ed.) (versão 5). Retrieved from www.juntadeandalucia.es/agenciacalidadsanitaria
Fortin, M.-F. (1996). O Processo de Investigação: Da concepção à realização. Lusociência.
Fujita, K., Halvorsen, K. H., Sato, N., Jazbar, J., Modamio, P., Waltering, I., … Teichert, M. (2023). Pharmaceutical Care Network Europe definition of quality indicators for pharmaceutical care: a systematic literature review and international consensus development. International Journal of Clinical Pharmacy. https://doi.org/10.1007/s11096-023-01631-8
Goode, J., Partnership, Y., & Trust, N. (2011). Key Performance Indicators within a pharmacy department.
Horvat, A., & Filipovic, J. (2017). Healthcare system quality indicators: the complexity perspective. Total Quality Management and Business Excellence, 0(0), 1–17. https://doi.org/10.1080/14783363.2017.1421062
http://www.ipac.pt/pesquisa/acredita.asp. (n.d.).
https://proqualis.net/. (n.d.).
https://proqualis.net/indicadores-de-medicamentos. (n.d.). Retrieved January 15, 2023, from https://proqualis.net/indicadores-de-medicamentos
https://www.eahp.eu/. (n.d.). Retrieved May 5, 2023, from www.eahp.eu
https://www.jointcommissioninternational.org/. (n.d.). Retrieved May 15, 2023, from www.jointcommissioninternational.org
Institute of Medicine. (2002). Crossing the Quality Chasm: A New Health System for the 21st Century. Journal For Healthcare Quality (Vol. 24). https://doi.org/10.1111/j.1945-1474.2002.tb00463.x
IPQ. (2015). NP EN ISO 9001:2015. Instituto Português Da Qualidade, 1–42.
Izadpanah, F., Shiehmorteza, M., Rahimpour, A., & Moradi, M. (2020). Prioritizing Medication Management Criteria of National Hospital Accreditation Standards Using FDANP Model. Journal of Pharmaceutical Research International, 69–77. https://doi.org/10.9734/jpri/2020/v32i330415
JCI, J. (2020). Joint Commission International accreditation standards for hospitals : including standards for Academic Medical Center Hospitals.
Kelley, E., & Hurst, J. (2006). Health Care Quality Indicators Project Conceptual Framework Paper.
Lo, E., Rainkie, D., Semchuk, W. M., Gorman, S. K., Toombs, K., Slavik, R. S., … Spina, S. P. (2016). Measurement of clinical pharmacy key performance indicators to focus and improve your hospital pharmacy practice. In Canadian Journal of Hospital Pharmacy (Vol. 69, pp. 149–155). Canadian Society of Hospital Pharmacists. https://doi.org/10.4212/cjhp.v69i2.1543
Lopes, H., Lopes, A. R., Farinha, H., & Martins, A. P. (2021). Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique. International Journal of Clinical Pharmacy, 43(6), 1660–1682. https://doi.org/10.1007/s11096-021-01298-z
Mainz, J. (2003, December). Defining and classifying clinical indicators for quality improvement. International Journal for Quality in Health Care. https://doi.org/10.1093/intqhc/mzg081
Marshall, M., Klazinga, N., Leatherman, S., Hardy, C., Bergmann, E., Pisco, L., … Mainz, J. A. N. (2006). OECD Health Care Quality Indicator Project . The expert panel on primary care prevention and health promotion, (September), 21–25.
Needs, I. (n.d.). Chapter 2. The Nature and Use of Indicators THE NATURE AND USE OF INDICATORS 2, 19–26. Retrieved from https://www.who.int/mediacentre/events/IndicatorsChapter2.pdf
Ogbeifun, E., & Agwa-Ejon. (2016). The Delphi technique: A credible research methodology.
OMS. (2011). Estrutura Concetual da Classificação Internacional sobre Segurança do Doente. Lisboa. Retrieved from http://www.who.int/patientsafety/taxonomy/ICPS_Statement_of_Purpose.pdf
Ordem dos Farmacêuticos. (2018). Manual de Boas Práticas de Farmácia Hospitalar, Capítulo A: Processos de Suporte. Manual de Boas Práticas de Farmácia Hospitalar (Vol. 1). Retrieved from https://www.ordemfarmaceuticos.pt/fotos/publicacoes/mbpfh_capitulo_i_vfinal_17815111995a8eee5ad0c17.pdf
Osório-de-castro, C. G. S., Lucia, V., & Pepe, E. (2007). Critérios e indicadores de resultados para a farmácia hospitalar brasileira utilizando o método Delfos Establishment of criteria and outcome indicators for hospital pharmacies in Brazil using Delphos, 23(8), 1791–1802.
Pencheon, D. (n.d.). The Good Indicators Guide : Understanding how to use and choose indicators.
República Portuguesa. Resolução No105/2000 do Conselho de Ministros, Pub. L. No. I Série-B, Diário da República 3953 (2000). Portugal: Casa da Moeda.
Rodríguez-González, C. G., Sarobe-González, C., Durán-García, M. E., Mur-Mur, A., Sánchez-Fresneda, M. N., Pañero-Taberna, M. de las M., … Sanjurjo-Sáez, M. (2020). Use of the EFQM excellence model to improve hospital pharmacy performance. Research in Social and Administrative Pharmacy, 16(5), 710–716. https://doi.org/10.1016/j.sapharm.2019.08.030
Shaw, C., Groene, O., & Berger, E. (2019). Chapter 8 External institutional certification , supervision, (September).
Sousa, P. (2019). Segurança do paciente: criando organizações de saúde seguras (2a Edição).
WHO. (n.d.). Global Patient Safety action Plan 2021-2030 towards Zero Patient Harm in Health care.
WHO. (2020). Manual de Políticas e Estratégias para a Qualidade: uma abordagem prática para formular políticas e estratégias destinadas a melhorar a qualidade dos cuidados de saúde. Genebra: Organização Mundial da Saúde.
