Frequently Asked Questions – Quality Indicators for Pharmacy
Quality Indicators for Pharmacy (FAQs)
(updated November 2020)
Jump To:A. Overall Scope and Purpose of the Quality Indicators for Pharmacy
Why did the College establish quality indicators?
To support its mandate to serve and protect the public, the College is responsible for assuring continuous quality improvement within the profession of pharmacy. Establishing quality indicators enables the College and pharmacy professionals to use data to promote a better understanding of the quality of pharmacy care and the impact pharmacy has on patient and system outcomes.
The initial focus is to provide pharmacy professionals and the public with information that will provide insight into the quality of pharmacy care and the impact of pharmacy at an aggregate level. Long-term, the College hopes to provide pharmacy professionals with information to support data-informed decision-making at the practice level.
What is the purpose of these indicators?
The purpose of these indicators is to improve the quality of pharmacy care and to increase transparency about the impact of pharmacy through aggregate level public reporting. Pharmacy professionals, like other health care professionals, play an active part in providing quality and safe care to patients while contributing to solutions to address common quality challenges experienced throughout our health system. Safe transitions of care, the opioid crisis, and medication-related hospital visits are just a few examples where pharmacy can play an increasingly valuable role in our health system, while continuing to contribute directly to a patient’s health goals. However, at this time there is no way to measure pharmacy’s impact on these issues.
What is the scope of these indicators? Is hospital pharmacy involved?
A strong focus on indicators already exists in other areas of the health system (for example in hospitals, primary care, long term care and home care), but community pharmacy is an area that has not historically been measured. A great deal of work has already been done to establish indicators in hospital pharmacy, including the efforts of the Canadian Society for Hospital Pharmacists. Since the primary gap is in community pharmacy, that is the current focus of the indicators work. However, it could potentially expand to other practice settings in the future.
B. The Process of Establishing the Quality Indicators for Pharmacy
How were the quality indicators established?
A collaborative approach was used by the College to establish the quality indicators, involving community and hospital pharmacists, patients, and representatives from the Ministry of Health and Long Term Care, the Ontario Hospital Association, the Ontario Pharmacists Association, and Health Quality Ontario (now Ontario Health, Quality). The process and timeline was as follows:
- Pharmacy Quality Roundtable – June 2018
Patient/Caregiver Experience and Outcomes; Provider (i.e. pharmacy professional) experience; Appropriateness of dispensed medications; Medication-related hospital visits; and, transitions of care were identified as priority areas for measurement at a stakeholder roundtable.
- Expert Panel formation – September 2018
The expert panel comprised 16 individuals, including patients, community and hospital pharmacists, health information and measurement experts, representatives from the Ministry of Health and Long Term Care, the Ontario Hospital Association, the Ontario Pharmacists Association, HQO and the College.
- Environmental Scan – October 2018
A list of indicator candidates was generated for consideration.
- Modified Delphi process – September 2018 to April 2019
A modified Delphi process was conducted, consisting of two surveys for independent rating of indicators and three consensus building meetings. This process was informed by extensive stakeholder (patient and sector) engagement.
- Patient and Sector Engagements – Nov 2018 to March 2019
Surveys of the Patient, Family and Public Advisors Network and pharmacy sector, and sessions with pharmacy professionals and corporate sector leaders were conducted.
- Final Indicator Selection – April 2019
A consensus was reached on seven quality indicators and future areas for indicator development were identified.
Have any changes been made to the indicators?
The indicators were originally established in 2019. The language used for each indicator may change due to a number of factors such as the indicator validation process, the data collection process or related technical specifications, best evidence in the literature or clinical best practices. Any changes made have been to ensure the indicators are as accurate as possible, while maintaining the original intent of the indicator. Up-to-date language is reflected on the Quality Indicators for Pharmacy webpage. More information on the version history can be found here.
C. Intended Indicator Use and Support to Implement the Indicators
How do the College’s quality indicators differ from other indicators, such as those being established by insurance providers?
These quality indicators for pharmacy are not intended to be used for quality assurance or to determine reimbursement. They are solely intended to provide the public and pharmacy sector with information about the overall quality of pharmacy care and to support the sector in gaining a better understanding of pharmacy’s impact on patient and system outcomes and drive quality improvement.
Will quality indicator data be shared with the public?
The quality indicators will be used for public reporting and for quality improvement within the sector. Pharmacist and pharmacy-specific data will not be shared publicly by the College. Only aggregate provincial and regional level data will be made public.
Will the quality indicators be used to assess individual pharmacists?
This initiative is not about tracking the performance of individual pharmacists, quality assurance or reimbursement. The College will report on aggregate indicator data for stakeholders to use for system-level continuous quality improvement. The College will then work with pharmacy professionals to determine which measures, data, and supports can be shared with pharmacies to support quality improvement efforts.
D. Related Initiatives
How is this initiative related to the AIMS program?
The Assurance and Improvement in Medication Safety (AIMS) Program is the College’s mandatory medication safety reporting program that has been implemented in all community pharmacies. The AIMS Program supports continuous quality improvement and puts in place a consistent standard for medication safety for all pharmacies in the province. By enabling practitioners to learn from incidents and better understand why they happen and how to prevent them, this program can reduce the risk of patient harm caused by medication incidents.
While the AIMS Program is a separate initiative to enable reporting on medication incidents and near misses to a third party for learning and improvement, both the AIMS Program and the quality indicators for pharmacy are part of the College’s efforts to promote quality improvement in pharmacy to support safe and effective patient care.
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