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Evaluation of quality indicators for Dutch community pharmacies using a comprehensive assessment framework
Tim W A Schoenmakers1, Martina Teichert, Jozé Braspenning
1Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. tim.schoenmakers@radboudumc.nl.
Journal of Managed Care & Specialty Pharmacy
|January 24, 2015
Summary
Only 25% of Dutch community pharmacy quality indicators (QIs) met all validity criteria. Improving QI validity requires defining meaningful pharmaceutical care outcomes and standardizing process measurement.
Area of Science:
- Pharmaceutical care quality assessment
- Health services research
- Indicator development and validation
Background:
- The Dutch Health Care Transparency Programme (Zichtbare Zorg) developed quality indicators (QIs) for healthcare, categorized for internal (formative) and external (summative) use.
- A comprehensive Indicator Assessment Framework (IAF) was established to validate QIs based on content validity, absence of selection bias, absence of measurement bias, and statistical reliability.
- The IAF was applied to assess the validity of QIs for Dutch community pharmacies, particularly those intended for summative use.
Purpose of the Study:
- To evaluate the validity of the 52 existing quality indicators (QIs) for community pharmacies in the Netherlands using the Indicator Assessment Framework (IAF).
Main Methods:
- An expert panel assessed 52 QIs from 1,807 Dutch community pharmacies using the IAF criteria.
- Judgments were categorized as meeting, partly meeting, or not meeting requirements for each criterion.
- Assessments considered QI type (structure, process, outcome) and predefined domains.
Main Results:
- Only 13 QIs (25%) met all IAF validity criteria, predominantly structure indicators (12) and one process indicator.
- Process indicators showed poor adherence to the measurement bias criterion.
- Outcome indicators demonstrated unsatisfactory content validity.
- The valid QIs covered 6 out of 10 domains, including continuity of care, clinical risk management, compounding, dispensing, management, and quality management.
Conclusions:
- A significant proportion of quality indicators for community pharmacies did not meet all validity requirements when assessed against the IAF.
- Enhancing the validity of process and outcome indicators necessitates clearer definitions of meaningful pharmaceutical care outcomes.
- Implementing uniform measurement standards for relevant processes is crucial for improving QI reliability and utility.
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