New Practice Assessments

Background

In 2015, the College introduced enhancements to the way it assesses pharmacy professionals by transitioning to practice assessments for community pharmacists. In January 2019, the College launched practice assessments for community and hospital pharmacy technicians.

These evaluations of an individual professional’s performance occur in the place of practice with a College practice advisor. They are separate and distinct from a pharmacy assessment, which assesses adherence to operational standards and processes, though they may take place during the same visit.

Practice assessments of pharmacists support their role as medication experts and clinical decision-makers, and are consistent with assessments of other primary healthcare practitioners. Practice assessments of pharmacy technicians support their role related to the technical elements of prescription and patient information and of product and drug distribution within the pharmacy or organization.

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 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.

Pharmacist Assessment Criteria

During a community pharmacist practice assessment, practice advisors focus on four key areas (categories):

  • Patient assessment
  • Decision making
  • Documentation
  • Communication and education

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.

Note that practice assessments for hospital and other healthcare facilities pharmacists are anticipated to commence in 2020.

Pharmacy Technician Assessment Criteria

During a community and hospital pharmacy technician practice assessment, practice advisors focus on the following four key areas (categories):

  • Patient Care Support Activities
  • Collaboration and decision making
  • Documentation
  • Communication and education

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 drug distribution activities, compounding practices, best possible medication histories and patient education activities.

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 checklist 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.

Next Steps

Practice assessments are now in place for pharmacists practicing in community pharmacy, with over 6,000 assessments having already taken place. It is anticipated that assessment standards for pharmacists practicing in hospital and other healthcare settings will follow. Assessments of pharmacy technicians in community and hospital settings were piloted in the fall of 2018 and launched in January 2019.