From Policy to Practice: Elevating Pharmacy’s Role in Quality and Patient Safety

In this interview, Josh Caraccio, PharmD, BCIDP, BCPS, Principal Implementation Engineer at Inovalon, discusses how pharmacy-led stewardship, near real-time data, and AI-enabled clinical surveillance can transform patient safety and organizational performance. Drawing on clinical background in infectious diseases and antimicrobial stewardship, Caraccio explains why stewardship must evolve from a “checkbox” compliance activity into a core patient safety and quality strategy that is embedded in an organization’s identity.

Caraccio begins by emphasizing that pharmacy stewardship—whether opioid, antibiotic, anticoagulation, or lab stewardship—should be framed first and foremost as a patient safety initiative, not merely a regulatory requirement. When stewardship is tied to outcomes such as harm reduction, avoidance of penalties, support for value-based contracts, and maintenance of accreditation, pharmacy moves from a secondary support role to a primary partner in safety, quality, and financial performance.

A central theme that Caraccio focuses on is the importance of data visibility and near real-time surveillance. Instead of relying on retrospective reports, clinical surveillance tools provide near real-time views of prescribing patterns and patient-level risk, enabling teams to intervene immediately, document interventions, and demonstrate continuous improvement. This capability is increasingly critical as the Joint Commission and CMS raise expectations for documented, effective antimicrobial stewardship and demonstrable performance improvement—not just written policies.

Furthermore, Caraccio explains how rule-based AI and surveillance should augment—not replace—clinical judgment by surfacing the right information at the right time. When pharmacy, infection prevention, and quality teams align around shared metrics and leverage the same data, they can break down silos, shift from compliance-focused meetings to continuous quality conversations, and tell a unified, data-driven story of improved patient care.

"Once you incorporate clinical surveillance in there, and you're incorporating all these different teams, then the risk is being brought to you, rather than you having to go hunt for it," Caraccio said.

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