Protected professional practice evaluation: A continuous quality-improvement process.

Area of Science:

• Pharmacy Practice
• Quality Improvement
• Healthcare Administration

Background:

• Advanced scopes of practice for clinical pharmacists necessitate robust evaluation methods.
• Ensuring high-quality patient care requires continuous monitoring and improvement.
• Peer review is a valuable tool for professional development and quality assurance.

Purpose of the Study:

• To describe the development, implementation, and evaluation of a protected peer-review process for clinical pharmacists.
• To establish a system for assessing advanced practice pharmacists' performance.
• To foster a culture of continuous quality improvement within pharmacy practice.

Main Methods:

• A protected practice evaluation committee (PPEC) was formed with six non-supervisory clinical pharmacists.
• PPEC developed performance measures and assigned peers to review clinical pharmacists' cases.
• A three-level rating system (level 1: similar care, level 2: slightly different care, level 3: significantly different care) was used.
• Data were protected from legal discovery and shared with management only in aggregate.

Main Results:

• Over 250 cases were reviewed, with 94.4% receiving level 1 care and 5.6% receiving level 2 care.
• The incidence of level 2 care decreased over time, indicating improvement.
• Positive trends were observed in process indicators like medication reconciliation and patient adherence documentation.
• A practitioner survey revealed strong support for the peer-review process.

Conclusions:

• Protected practice evaluation effectively engaged clinical pharmacists in quality improvement.
• The process generated data on both individual and practice-wide performance.
• The initiative encouraged self-reflection and was deemed important for quality improvement by practitioners.