American Hospital Association, Chicago, IL.
Immunization Health Branch at United States Army, Washington, DC.
Am J Health Syst Pharm. 2019 Jun 3;76(12):874-887. doi: 10.1093/ajhp/zxz069.
Pharmacists are accountable for medication-related services provided to patients. As payment models transition from reimbursement for volume to reimbursement for value, pharmacy departments must demonstrate improvements in patient care outcomes and quality measure performance. The transition begins with an awareness of quality measures for which pharmacists and pharmacy personnel can demonstrate accountability across the continuum of care. The objective of the Pharmacy Accountability Measures (PAM) Work Group is to identify measures for which pharmacy departments can and should assume accountability.
The National Quality Forum (NQF) Quality Positioning System (QPS) was queried for NQF-endorsed medication-related measures. Included measures were curated into a data set of 6 therapeutic categories: antithrombotic safety, cardiovascular control, glucose control, pain management, behavioral health, and antimicrobial stewardship. Subject matter expert (SME) panels assigned to each area analyzed each measure according to a predetermined ranking system developed by the PAM Work Group. Measures remaining after SME review were disseminated during a public comment period for review and ballot. Over 1,000 measures are captured in the NQF QPS; 656 of the measures were found to be endorsed and medication use related or impacted by medication management services. A single reviewer categorized 140 measures into therapeutic categories for SME review; the remaining measures were unrelated to those clinical domains. The SME groups identified 28 measures for inclusion.
An understanding of the endorsed quality measures available for public reporting programs provides an opportunity for pharmacists to demonstrate accountability for performance, thus improving quality and safety and demonstrating value of care provided.
药剂师负责向患者提供与药物相关的服务。随着支付模式从按数量报销向按价值报销转变，药房部门必须证明在改善患者护理结果和质量措施绩效方面取得了进展。这一转变始于认识药剂师和药剂人员可以在整个护理连续体中证明对哪些质量措施负责。药房责任措施（PAM）工作组的目标是确定药房部门可以且应该承担责任的措施。
国家质量论坛（NQF）质量定位系统（QPS）被查询了 NQF 认可的与药物相关的措施。纳入的措施被整理到一个包含 6 个治疗类别的数据集：抗血栓安全性、心血管控制、血糖控制、疼痛管理、行为健康和抗菌药物管理。每个领域的主题专家（SME）小组根据 PAM 工作组制定的预定排名系统分析了每个措施。在 SME 审查后，剩余的措施在公开评论期内进行审查和投票。NQF QPS 中捕获了超过 1000 项措施；其中 656 项措施被认为是认可的，与药物管理服务相关或受其影响。一名审查员将 140 项措施归类为 SME 审查的治疗类别；其余措施与这些临床领域无关。SME 小组确定了 28 项措施纳入其中。
了解可用于公开报告计划的认可质量措施，为药剂师展示绩效责任提供了机会，从而提高质量和安全性，并展示所提供护理的价值。
