I started my pharmacy career in hospital pharmacy. As a hospital pharmacy director and a hospital pharmacy educator, I saw the value of an external review of a hospital pharmacy program. In my era, the Joint Commission on Accreditation of Hospital Organizations (JCAHO) served this role. Because of an expansion in the types of accreditation programs it offers, its name is now The Joint Commission. Its mission is to continuously improve health care for the public in collaboration with other stakeholders by evaluating health care organizations and inspiring them to provide safe and effective care of the highest quality and value.
I can remember how my hospital was on edge when a JCAHO visit was pending. Frequently, I used JCAHO standards in justifying my requests, as a hospital pharmacy director, to expand hospital pharmacy services. I taught my students that JCAHO standards, along with American Society of Health-System Pharmacists (ASHP) standards, served as guidance on what constituted a quality hospital pharmacy operation. For these reasons, I became a strong proponent of establishing a community pharmacy accreditation program.
The National Alliance of State Pharmacy Associations has offered the Pharmacy Quality Commitment (PQC), a quality assurance improvement program, for many years. While trying to promote this product to our members when I ran a state pharmacy association, I soon realized that community pharmacists, like hospital pharmacists, seemed content with what they did and how they did it. Too many community pharmacists think they are doing everything right, so no operational change is needed.
I saw that the application of standards that were achievable but stretched the status quo would be beneficial for patients and would also advance community pharmacy
practice. Clearly, there are other ways besides an accreditation program to advance pharmacy practice and benefit patients, but I believe that an accreditation process may be the most important.
Community pharmacy accreditation can be a tool to help advance practice. Since it is a voluntary program, only those interested in using it to help advance their personal practices would participate. If I were satisfied with my operation, I wouldn’t have to participate. I do like the voluntary aspect of an accreditation program.
Another resource for advancing pharmacy practice is Pharmacy Quality Alliance (PQA). PQA’s mission is to develop performance measures and recognize examples of exceptional pharmacy quality. These performance measures can focus attention on quality and can benefit patients and advance practice. Performance measures have a role to play, too, but PQA or PQC only focuses on parts of the whole. I believe that an accreditation program brings all the tools together as it focuses on the whole entity.
There are currently 2 community pharmacy accreditation programs. URAC is an independent nonprofit organization that promotes health care quality through accreditation and other efforts. It offers a Community Pharmacy Accreditation Program, and CVS/Pharmacy recently announced that it is stepping forward to be the first applicant organization to seek community pharmacy accreditation from URAC.
The other accreditation program is run by the Center for Pharmacy Practice Accreditation (CPPA). CPPA is a partnership established by the American Pharmacists Association (APhA), the National Association of Boards of Pharmacy, and the ASHP to oversee accreditation of pharmacy practice sites. On May 29, 2014, CPPA announced the first 2 programs to be accredited under its community pharmacy standards: Goodrich Pharmacy, an independent multisite community pharmacy, and the Johns Hopkins Outpatient Pharmacy.
Does community pharmacy need 2 different accreditation programs? Probably not, although some would suggest that competition can make both programs better. We certainly don’t need one program that accredits independent pharmacies while the other accredits chain pharmacies, either. The old divide between independent and chain pharmacy has been erased, as all now collaborate to seek pharmacy provider status. Let’s hope the divide doesn’t reemerge around accreditation programs. As we watch the marketplace sort out the situation, the real winners may be the patients. At least I hope so!
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