Feasibility of a Hospital Peer Review Continuous Quality Improvement Program for Pharmacists' Documentation: A Mixed-Methods Study.

Abstract

Peer review to assess the quality of documentation is essential, as it provides a framework for constructive feedback, using evaluators with similar qualifications to increase acceptability. To determine the feasibility of implementing a peer review continuous quality improvement program for pharmacists' documentation at the Montreal Children's Hospital. A prospective, single-centre mixed-methods feasibility study was conducted (from January to June 2021) to evaluate the practicality and acceptability of a peer review program (PRP) for assessing the quality of pharmacists' documentation. A peer review committee of 5 pharmacists evaluated their peers' clinical notes using a standardized assessment tool. Practicality was determined through the time required for administrative and evaluative tasks and the resources needed for each evaluation cycle. Acceptability was determined through pooled quantitative data related to pharmacists' perceived relevance of the PRP, confidence in their peers, and satisfaction with the evaluation process. Qualitative data collected through surveys, a focus group, and semistructured individual interviews helped to further explain the results. A total of 37.4 hours was required to complete both administrative and evaluative tasks in one peer review cycle, which respected the budgeted cut-off for practicality. Acceptability was also achieved, given that more than 80% of survey respondents found the PRP relevant to their practice, were confident in their peers, and were satisfied with the PRP. Qualitative results showed that participants found the PRP to be instructive and that qualitative feedback was preferred over a grade issued as a percentage. This study showed that it is feasible to implement a PRP to assess the quality of pharmacists' documentation. To ensure success, it is key that documentation objectives and department resources be predefined.