November 16, 2018

Quality Indicators for Pharmacy: A focus on patient outcomes

Webinar Session

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Agenda

• Provide an overview of the need for Quality Indicators for Pharmacy in accordance with the College mandate

• Clarify the purpose of the Quality Indicators for Pharmacy

• Outline the indicator selection process and implementation considerations

• Provide an opportunity for questions

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The College’s mandate is to

serve and protect the

public

We Are Transforming Our Approach…

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From pharmacy as a silo to system-based thinking

From process measurement to system

outcomes

From anecdotal evidence to data that can be measured,

analyzed and acted on

Public Service & Protection Mandate

A Leveled Approach

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Public Accountability

System Monitoring

Local level self monitoring

Adapted from Ontario Hospital Association

What is a Quality Indicator? • “Quality measures are tools that help us measure or quantify

healthcare processes, outcomes, patient perceptions, and/or systems that are associated with the ability to provide high-quality healthcare and/or that relate to one or more quality goals for healthcare.” (Centers for Medicare & Medicaid Services)

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• The indicator reflects an issue that is important to the general population and to relevant health system stakeholders.

• Quality Indicators are commonly used to track the quality of Ontario’s health system

• Hospital wait times is a popular example

Quality Indicators in the Health System…

• Long term care:

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0

5

10

15

20

25

30

35

40

2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

Percentage of long-term care home residents not living with psychosis who were given antipsychotic medications, in

Ontario, 2010/11 to 2016/17 Ontario (Percent)

Health Quality Ontario

Quality Indicators in the Health System…

• Surgery:

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95 9597 97 96 96 96 97 97 97 97 96 96

50

60

70

80

90

100

2017/09 2017/10 2017/11 2017/12 2018/01 2018/02 2018/03 2018/04 2018/05 2018/06 2018/07 2018/08 2018/09

Percentage of patients whose surgery was completed within the provincial target wait time, in Ontario, 2017/09 to 2018/09

Health Quality Ontario

…Quality Indicators for Pharmacy

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Overarching Goals

1. Measure and report on quality of pharmacy care in a way that is important to patients

2. Measure areas where pharmacy can have an impact, with a focus on broader health system priorities

3. Align with HQO’s quality domains and the quadruple aim

4. Use the indicators to support continued culture of quality

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A Regulatory Lens on Quality Indicators

• As the regulator of pharmacy in Ontario, the mandate of the College is to serve and protect the public

• As such, the College aims to measure the impact of pharmacy practice on patient outcomes

• These indicators will be used for quality improvement and to increase transparency of the impact of pharmacy to the public

• These indicators will NOT be used for measuring performance or for quality assurance purposes

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How Will These Indicators Be Used?

• Indicators will be used for Quality Improvement, increasing transparency among the public about the impact of pharmacy

Purposed for QI notintended for assessment

• The indicators are not intended to be used for determining reimbursement.

Not related to reimbursement model

• Pharmacy/pharmacist-specific data will not be shared publicly

Pharmacist and pharmacy-specific data

will not be shared publicly

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Indicator Selection Process & Implementation Considerations

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Championing, Collaborating, Learning

Collaboration and

commitment to working as a

system for the benefit of patients

Engaging, sharing and learning from

one another

Championing the value of standardized system-focused indicators of

pharmacy quality

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Collaborating with Health Quality Ontario (HQO)

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Roundtable: June 2018Attendees

Patients & providers (including pharmacists)

Health management and measurement experts

Representatives from MOHLTC & LHINs

Insurance providers

Advocacy bodies & associations

Health Quality Ontario & the College

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Roundtable: June 2018

Synopsis Document

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What were the objectives?1. Achieve a consensus on overarching

goals for quality indicators

2. Identify indicator themes/areas to measure

3. Review indicator selection criteria

4. Outline principles for implementation

Which Areas Were Identified As Important To Measure?

• Patient / Caregiver Experience & Outcomes

• Provider Experience

• Appropriateness of dispensed medications

• Medication-related incidents / hospital visits

• Transitions of care

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Expert Panel: November 2018Composition

• 16 panel members in total

• 7 Part A RPhs & 3 Patient Advisors

• Representatives from Neighbourhood Pharmacy Association of Canada, Ontario Pharmacists Association & Ontario Hospitals Association

• Representatives from MOHLTC, experts in data analytics, researchers & policy makers

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Expert Panel: Primary Objective

• To review potential indicators and shortlist a set of approximately five quality indicators to recommend for quality improvement and consideration for public reporting on pharmacy, using a modified Delphi process

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Expert Panel: Selection Criteria• Is this indicator…

• Measurable? • Evidence-based? • Important/relevant to pharmacy? • Actionable? • Interpretable? • Feasible?• Data quality?

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Quality Indicators for Pharmacy: Next Steps

KEY MEASUREMENT AREAS IDENTIFIED

FINAL REPORT (Spring 2019)

PUBLIC REPORTING QUALITY IMPROVEMENT AND CHANGE MANAGEMENT

DATA CAPTURE AND SHARING CONSIDERATIONS22

EXPERT PANEL INDICATOR SELECTION PROCESS (Fall 2018 – Winter 2019)

SECTOR/PUBLIC ENGAGEMENT (Fall 2018 &

Spring 2019)

Implementation Goals

Result: Quadruple Aim

Patient experience Population health Reducing Costs Care team well-being

Implementation Goals Intended Results

Understand quality of pharmacy care & impact on patients

Increased capacity for QI in pharmacy sector

Further data analytic capacity in pharmacy

Roundtable Feedback on Implementation

Need clear audience and purpose

Focus on quality improvement and public reporting

Indicators supplemented with training & tools

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What Does This Mean For The Profession?

QI

Having resources and

support to make a greater

impact on patient

outcomes

Being seen as an integral part

of the health system

Transparency to the public

on the impact of pharmacy

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Next Steps for Webinar Attendees

• All attendees will receive an email with an opportunity to provide written feedback on a set of questions

• Interested individuals will be contacted for future engagement opportunities

• Please look out for future communication from the College

• Recording of webinar and a Q & A document will be available

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Questions?

THANK YOU

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