Value of Quality Measures

Quality measures are used by health plans, pharmacists, physicians, and other health professionals to evaluate their services and continuously improve the care that is delivered. These measures help healthcare groups showcase patient satisfaction and clinical performance as well as set achievable goals. With the rapid changes in healthcare, quality metrics are also used to hold providers accountable for their patients’ health.

Pharmacist’s Contributions to Quality Measures 

Pharmacists are recognized as medication experts. Their expertise has proven to prevent medication errors, decrease costs, and improve medication and health outcomes. As quality measurement continues to grow in the health system, pharmacists can play a key role in contributing to their practice or organization meet relevant quality metrics.

Quality measures give pharmacists a platform to demonstrate their contributions and potentially receive reimbursement for their efforts. The value-driven health care models recently promoted by the Federal government, create new opportunities for pharmacists to demonstrate their value as members of the healthcare team.

Donebedian SPO Framework

The structure-process-outcome (SPO) framework is recognized as the basis for quality measures. Donabedian developed this framework so that it could be applied to any healthcare setting to assess the quality of care.

When addressing medication-related measures, the SPO framework directly correlates with the role of pharmacists. The Pharmacy Quality Alliance uses the following three examples as realistic scenarios to show the value of pharmacists:

• Structure: Medication profiles, pharmacists, and warfarin clinics fall into the category because these are factors that affect how services are delivered.
• Process relates to the provision of services. For pharmacists, this includes reviewing medication profiles, counseling patients, and monitoring patient progress to goals.
• Outcomes: Sample outcomes include adverse effects, adherence/medication effectiveness, and incidence of bleeding events.

Medication management and patient safety are core duties of pharmacists and key components of providing quality patient care. Thus, the participation of pharmacists in quality and performance improvement leadership roles is vital to the overall success of a healthcare system. Pharmacists are well-equipped to fulfill the responsibilities of these roles, and they are capable of making sound patient-centered decisions. Pharmacists’ familiarity with different facets of the healthcare system equips them with the skills needed to reform and design quality improvements.

The financial burden of collecting data is typically noted as a barrier for healthcare providers to integrate quality measurement into their practice.  Some major expenses include the cost of data collection software, electronic health record technology, and employee salaries associated with analyzing the data. Pharmacists should consider these reports an investment to enhance patients’ experience and the competitive ability of the practice.

The United States does not have a department or agency that focuses solely on the delineation of quality measurement or quality reporting. Consequently, several organizations have been formed to create measures and report them. These multiple sources create an environment where there is not a single harmonized system.

The major benefit of quality measures is the improvement of patient care. Efficient analysis of provided services and performance can be conducted through quantitative evaluation. For pharmacies, the rewards for high performance include new reimbursement opportunities and increased acknowledgment from health care plans. As more pay-for-performances and value-based models arise, pharmacists can seek to capitalize on this quality-based movement.  Demonstrating exceptional service and reaching benchmarks may persuade plans to offer pharmacies financial bonuses or inclusion in a preferred pharmacy network status.