Total Quality Management Approach to Drug and Therapeutics Committee Guidelines in a Tertiary Care Government Hospital in Nepal

Abstract

Background: Drug and Therapeutics Committee (DTC) is the principal policy making and recommending body for Civil Service Hospital (CSH). Condition of no functional DTC and guidelines based on the concept of total quality management (TQM) continuously presented inconsistencies health care delivery system at CSH. The present study was carried out at CSH from March 2012 to October 2015. Objective: The present guidelines were targeted to the prescribers, pharmacists, and nurses for providing rational health care and disseminating uniform and state-of-art medicine information at CSH. Methods: The present study was carried out at CSH from March 2012 to October 2015. The FOCUS-PDCA concept of TQM included following nine aspects: F: Find role of DTC for the improvement in the existing practice; O: Organize trained team knowledgeable of the process; C: Clarify operational definitions of DTC; U: Understand functions of DTC; S: Select rules and regulations for DTC members; P: Plan improvement procedures through the DTC meeting; D: Do improvement in DTC process; C: Check and analyze the results or outcomes obtained from the implementation of DTC guidelines; A: Act to explore the extent and scope of the guidelines. Results: The present guidelines were developed based on the FOCUS-PDCA concept of TQM. DTC also developed quality assurance criteria, medicine information provision, pharmacovigilance center, pharmacoeconomic evaluation criteria and defined roles and responsibilities of the members. Conclusions: DTC guidelines were developed at GoN CSH, based on FOCUS-PDCA model of TQM approach. The guidelines were based on rational pharmacotherapeutics concepts.