Outcome-focused counseling program for quality assurance in ambulatory care

An outcome-focused patient-counseling program designed to enhance quality assurance in ambulatory pharmaceutical care is described. Drugs for which counseling was mandatory because of their potential for association with an adverse outcome were listed. A checklist was created for each drug class to assist pharmacists in providing uniform information and to serve as a follow-up document for quality assurance. The completed forms are used to indicate which patients' charts should be pulled for review against quality assurance criteria for the monitored drug classes; the criteria function as indicators of an adverse outcome. Findings are summarized and presented at the monthly meeting of the departmental quality assurance committee. The program was phased in one drug class at a time. Between October 1988 and January 1989, 18 charts were reviewed for the two drug classes being monitored during that period. There were no patients to whom the indicators of an adverse outcome applied. The outpatient-counseling program helped pharmacists to provide consistent information and to focus on those drugs with the highest potential for adverse outcomes. Incorporating the program into quality assurance activities made it easier to measure patient outcomes.