Measures of Health Care Quality
Health care quality can be measured by many ways. One of the
frameworks most widely used is one suggested by Donabedian. He
stated that quality measures can be divided into following three
categories:
Structures
These are measures of the presence of something that is
reasonably associated with quality.
Desirable for assessing the quality of health care because
they are easy to measure.
Structures That Should Be Present For Ensuring Safe
Medication Use
Formulary system, governed by a multidisciplinary pharmacy and
therapeutics committee should have responsibility for
formulating policies regarding the evaluation, selection, and
therapeutics use of drugs .
Effective human resources management must be present to
effectively hire, manage, and train personnel involved in
medication ordering, preparation, dispensing, administration,
and patient education.
Adequate staffing must be available to perform tasks effectively
and ensure reasonable employee work-loads and working hours.
Suitable work environments should exist that minimize
interruptions and distractions that might cause errors.
Lines of authority and areas of responsibility within the
medication use process should be clearly defined for all
individuals involved.
An ongoing, systematic program of quality improvement and
peer review relating to the safe use of medications should be
present.
Clinical information about patient about patient needs to be
available to pharmacists and other responsible for processing
drug orders.
Patient medication profiles should be maintained for all patients.
The pharmacy department must be responsible for the
procurement, distribution, and control of all drugs used within
the organization.
Computerized pharmacy systems should be in place to automate
the drug use process and provide better management of
information.
Unit dose systems are strongly recommended as the preferred
method of drug distribution.
Pharmacist should have access to electronic health records.
Computerized prescriber order entry is preferred method for
prescribing medications order.
Medication references should be available to all health providers.
Standard drug administration times should be established to
ensure consistency in when patients receive drugs
Standard abbreviations should be established for medication
ordering.
A review mechanism must be in place to conduct retrospective
reviews of drug-related problems.
Educational programs should be in place to discuss medication
errors, their causes, and methods to prevent their occurrence.
Process
Actions reasonably associated with quality such as
checking of patient medication profiles prior to dispensing,
double checking technician work, and electronic
prescribing.
Widely accepted practices are not always associated with
positive patient health consequences.
Outcome
Quickly becoming the main focus of developers, regulatory
groups, and researchers.
Track the desired states resulting from care processes and
demonstrate the effect structure and process measure
types have on the patient. They measure the result of the
entire care process.