Pharmacy CQI: Monthly Rx safety audits

February 15, 2011

There are 2 measures of success every pharmacy should post on its wall. The first indicates percentage of QREs (quality-related events) in prescription fills, and the second measures the percentage of QREs caught before they reach the patient.

Key Points

I was asked to participate in training pharmacy personnel in medication safety and continuous quality improvement (CQI). In addition, we were to institute a method of measuring quality in participating pharmacies and telepharmacy sites.

Is it working?

If a pharmacy, be it community, long-term care, or hospital, cannot answer that question, its CQI program of medication error reduction is not complete. The final step in continuous quality improvement is to monitor progress and use that information to analyze and look for lingering vulnerabilities in its workflow.

No matter how sophisticated a pharmacy's quality system is, risk of error will still exist. There will always be vulnerabilities to fix and there will always be changes that need to be made to further refine the system. While the goal in a CQI system is "perfection," it will never be reached. The system will never be complete.

Measuring success

There are 2 measures of success every pharmacy should post on its wall. I refer to these measurements collectively as "Monthly Safety Audits." Both should be posted each month and compared with results for prior months.

The best way to compare is to draw a month-to-month graph using error and near-miss information as the graph point for each month. It should be a simple graph and, hopefully, the line of success should be going up.