School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK.
Res Social Adm Pharm. 2012 Sep-Oct;8(5):360-70. doi: 10.1016/j.sapharm.2011.09.001. Epub 2012 Jan 4.
There is currently no common frame of reference defining community pharmacy quality. It can therefore be difficult to know whether the provision of care meets minimum standards and how to improve quality of care.
The aim of this research was to develop a conceptual framework characterizing healthcare quality in the community pharmacy setting.
Ten focus group discussions with 47 participants were conducted across the northwest of England, United Kingdom. All participants had experiences of health care provided by community pharmacies and included patients and their carers, pharmacists and pharmacy staff, and National Health Service staff who commissioned pharmacy services. Constant comparative analysis was used to analyze the verbatim transcripts.
Community pharmacy quality can be conceptualized as dynamic with 3 interdependent dimensions. Each dimension was associated with structures, processes, and outcomes. The first dimension (accessibility) emphasized that in addition to patients requiring access to the available services, medicines, and health care advice, it was equally important for pharmacy personnel to have access to adequate structures to provide quality health care. The second dimension (effectiveness) highlighted a shift away from simply supplying medicines to supplying medicines appropriately, from passively providing services and information to individualizing advice to achieve intended outcomes, and from having structures available to using them purposefully to achieve outcomes. The third dimension (positive perceptions of the experience) enabled patients and carers to better care for themselves and for others, and it influenced future access. At the same time, when pharmacy personnel believed themselves to be valued and that they had done a good job, they felt motivated to continue to provide high-quality care.
All 3 dimensions should be considered when the term quality is used in the context of community pharmacy. This research can be used as a springboard for similar studies in other sectors or jurisdictions wishing to characterize quality for their health care services. In particular, this research provides a common frame of reference for those interested in the provision and assessment of quality health care from community pharmacies.
目前尚缺乏一个通用的参考框架来定义社区药房的质量。因此，很难知道所提供的护理是否符合最低标准，以及如何提高护理质量。
本研究旨在构建一个概念框架，以描述社区药房环境中的医疗保健质量。
在英国西北部进行了 10 次焦点小组讨论，共有 47 名参与者参加。所有参与者都有社区药房提供的医疗保健经验，包括患者及其照顾者、药剂师和药房工作人员以及委托药房服务的国家卫生服务人员。使用恒定性比较分析对逐字记录进行分析。
社区药房质量可以被概念化为具有 3 个相互依存的维度的动态过程。每个维度都与结构、过程和结果相关联。第一个维度（可及性）强调，除了患者需要获得可用的服务、药品和医疗保健建议外，药剂人员获得充足的结构来提供高质量的医疗保健同等重要。第二个维度（有效性）强调从简单地供应药品转变为适当地供应药品，从被动地提供服务和信息转变为个性化建议以实现预期结果，以及从有结构可用转变为有目的地使用它们以实现结果。第三个维度（对体验的积极看法）使患者和照顾者能够更好地照顾自己和他人，并影响未来的就诊。同时，当药剂人员认为自己受到重视并且他们做得很好时，他们会感到有动力继续提供高质量的护理。
在社区药房的背景下使用“质量”一词时，应考虑所有 3 个维度。这项研究可以作为其他部门或司法管辖区希望为其医疗保健服务确定质量的类似研究的基础。特别是，这项研究为那些对从社区药房提供和评估高质量医疗保健感兴趣的人提供了一个通用的参考框架。
