Building the frameworks to implement the continuous quality improvement philosophy related to pharmaceutical care.

Cruickshank, Gillian M.

Abstract

The provision of high quality patient care, together with the need to accurately assess this care, is paramount to the effectiveness of healthcare delivery. Pharmacy has yet to meet these challenges. Research questions & Aim: i) What are the component parts of clinical pharmacy services in Tayside hospitals? and ii) Are audit and peer review suitable methods for assessing the quality of clinical pharmacy services in Tayside hospitals? By applying the principles of continuous quality improvement (CQI) to pharmaceutical care, this research study has developed a framework to describe the component parts of clinical pharmacy services in Tayside hospitals. Design: Several small studies were brought together: Study 1: The component parts of clinical pharmacy were compiled by clinical pharmacists (CPs), applied by questionnaire and then extended by study grouping. Study 2: Audit and peer review approaches were carried out on the established component parts. Study 3: Data sources of pharmaceutical care issues were identified by CPs. Study 4: Service specifications were created and an automated data collection system for clinical pharmacy activities established. Setting: 3 NHS Trusts in Tayside. Subjects: 25 senior CPs consented to the studies, although the numbers varied in each. Results: Study 1: Variations were highlighted in practice and perception of pharmaceutical care amongst the CPs. Two sections of 12 core criteria were established to describe the component parts of clinical pharmacy: a) Patient Group Specific Activities and b) Direct Patient Care Activities. Study 2: Standards achieved a baseline measure for self and peer comparison. Study 3: 72% of all patients required input by CPs and 45% of care issues were identified by the medicine chart alone. Study 4: A service specification training programme was devised and CPs created their own service specifications. CP activities were segregated into three and differences highlighted, of the 446 activities recorded over 80 days: {145 (33%) patient group specific, 216 (48%) direct patient care and 85 (19%) other}. Conclusion: The component parts of clinical pharmacy were identified, audited and peer reviewed. A system for the development of clinical pharmacy standards was developed and used to create measures. Variations were highlighted amongst the CPs in their practice of clinical pharmacy. Audit and peer review encouraged the further development and application of clinical skills to evaluate and improve the quality of service.

Citation

CRUICKSHANK, G.M. 2000. Building the frameworks to implement the continuous quality improvement philosophy related to pharmaceutical care. Robert Gordon University, PhD thesis. Hosted on OpenAIR [online]. Available from: https://doi.org/10.48526/rgu-wt-2807339

• Thesis Type: Thesis
• Deposit Date: Jul 3, 2025
• Publicly Available Date: Jul 3, 2025
• DOI: https://doi.org/10.48526/rgu-wt-2807339
• Public URL: https://rgu-repository.worktribe.com/output/2807339
• Award Date: Jul 31, 2000