New Practice Assessments
In 2015, the College introduced enhancements to the way it assesses pharmacy professionals by transitioning to practice assessments for community pharmacists. These evaluations of an individual professional’s performance occur in the place of practice with a College practice advisor. They are separate from a pharmacy assessment, which assesses adherence to operational standards and processes, though they may take place during the same visit.
The new practice assessments support the role of pharmacists as medication experts and clinical decision-makers, and are consistent with assessments of other primary healthcare practitioners.
The practice assessments are also a critical component of quality assurance, which exists to ensure that pharmacy professionals maintain appropriate skills and knowledge throughout their careers and is a core part of the College’s mandate. The transition to assessments at the individual’s place of practice also reflects evolving public and patient expectations that the College regularly engages with pharmacists and pharmacy technicians to ensure that safe and appropriate patient care is being provided.
During a community pharmacist practice assessment, practice advisors focus on four key areas (categories):
- Patient assessment
- Decision making
- Communication and education
For each focus area, specific standards – which describe the minimum practice requirement for all professionals – are identified. The guidance section illustrates how the standards will apply in practice and provides examples of activities that support each standard.
Through a combination of observation and retrospective review of documentation (chart stimulated recall) practice advisors evaluate the processes in place for each of these areas with respect to new and refill prescriptions, adaptations/renewals, comprehensive medication reviews and patient interactions related to over the counter medications.
Shift to Coaching
Although the addition of practice assessments at the place of practice is a substantial change to the College’s quality assurance activities, perhaps the more significant change is the College’s shift to using coaching and feedback to support the identification and implementation of opportunities for pharmacy professionals to enhance their practice. Traditionally, inspections of pharmacies focused on a check-list of the pharmacy’s adherence to legislation, policies and standards relevant to pharmacy operations, which the College still does evaluate through pharmacy assessments. However, less attention was placed on the processes and procedures that shape and support an individual professional’s practice and clinical decision-making, although these can have a significant impact on patient safety and quality care.
Throughout and following a practice assessment, the practice advisor provides feedback outlining areas of practice where the pharmacy professional is doing well and meeting standards as well as areas where there is an opportunity for improvement. They offer support through coaching and conversation, pointing out opportunities to enhance practice, probing the thinking behind certain practice and decisions, and indicating where to access helpful resources.
With an emphasis on educating, the goal of the practice assessments is to increase adherence to practice standards, help pharmacy professionals use their full scope, and ultimately support optimal health outcomes. The results of a practice assessment are confidential and are not shared with employers, owners, colleagues or any College committee, other than the Quality Assurance Committee.
Practice assessments are now in place for pharmacists practicing in a community setting, with over 6,000 assessments having already taken place. The College is currently developing assessment standards for pharmacy technicians and a pilot program is expected to commence in late Spring 2018. It is anticipated that assessment standards for pharmacists practicing in hospital and other healthcare settings will follow .