Improving use of medicines with clinician‐led use of validated clinical indicators

Abstract

se of clinical indicators with collection and monitoring of meaningful data has been recognised as important for driving improvements in the safety and quality of health care. 1 Quality Use of Medicines (QUM) is one aspect of health care in which continual improvement is vitally important. QUM forms part of Australia’s National Medicines Policy and involves judicious selection of treatment options (including choice between drug or non-drug treatment and no treatment), appropriate choice of medicines when they are required, and safe and efficacious use of medicines. 2 Problems with medicines use are costly and occur commonly at all stages of the medicines management pathway 3 and in all health care settings. Elderly, paediatric and chronically ill patients are at particular risk of experiencing adverse drug events. In Australia, some 190 000 admissions per year are associated with medicinerelated problems, costing the health care system about $660 million, and adverse events involving medicines are consistently among the most frequently reported incidents in voluntary incident-reporting systems. 4 Thus, to stimulate quality improvement in this area of health care, it is critical to systematically collect meaningful data about medicines use. Organisations such as the Australian Commission on Safety and Quality in Health Care, the Australian Council on Healthcare Standards (ACHS), the Australian Institute of Health and Welfare, the Council of Australian Governments and the National Prescribing Service are developing clinical indicators for measuring and improving the safety and quality of health care. However, QUM issues are addressed inconsistently in indicators relating to hospitalised patients — probably because medicines management is complex and multidisciplinary 3 and not wholly “owned” by any one profession, specialty or discipline.