Abstract
Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged. Methods Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC). Results For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies. Conclusions A set of validated quality indicators provided insight into the quality of pharmaceutical care in the Netherlands. The quality of pharmaceutical care improved over time. As of 2012 quality structures were present in at least 80 % of the community pharmacies. Variation in scores on care processes and outcomes between individual pharmacies and over time can initiate future research to better understand and facilitate quality improvement in community pharmacies.
Highlights
Aim of the studyQuality indicators in healthcare address measurable aspects of relevant systems, processes and outcomes
This study aimed to present a comprehensive quality indicator set for community pharmacies and to report the scores for these indicators as supplied by the majority of Dutch community pharmacies
A comprehensive set of 66 quality indicators across 10 categories was developed by pharmacists and major stakeholders to continuously improve pharmaceutical care and to compare indicator scores between community pharmacies
Summary
Quality indicators in healthcare address measurable aspects of relevant systems, processes and outcomes They provide insight into the performance of care providers and are used to stimulate continuous improvement of patient care [1]. To assess pharmaceutical care as the pharmacist’s contribution to the care of individuals in order to optimize medicines use and improve health outcomes [9], in 2008 a national set of quality indicators has been established for community pharmacies in the Netherlands [10]. This was initiated by the Royal Dutch Pharmacists Association (KNMP) and the Netherlands Healthcare Inspectorate. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged
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