Quiz 2 Sunday, October 27, 2024 10:50 PM Quality Assurance • What is quality (Slide 4) ○ Quality is defined as a “degree of excellence.” ▪ This can be quite subjective ○ Quality Medical Care can be defined as: ▪ An evaluation of the degree to which the care given increases the probability of outcomes desired and reduces the probability of undesired outcomes while remaining consistent with medical knowledge ▪ Gives patients what they want and need ▪ Do patients always know what they need from the medical care they receive? • Quality in pharmacy practice (Slide 5) a. Represent a degree of excellence b. Increase the probability of positive outcomes c. Decrease the probability of negative outcomes d. Correspond with current Medical knowledge e. Offer patients what they want and need As quality improves, a corresponding improvement in productivity is seen. • QA vs QC vs CQI (Slides 9 & 10) QA (Quality Assurance) ○ QC (Quality Control) CQI (Continuous Quality Improvement) • Systematic monitoring and evaluation • An aggregate of activities, defect • Philosophy of continual improvement of of various aspects of a project or prevention the process. Transcends QA and QC. service to ensure standards are • Final pharmacist check All workers within the systems are being met. • Required by BOP interconnected. Focus is on • Retrospective review of what identification of the root cause via went wrong. After an error has scientific methodology. CQI is been made.....Peer review. continuous and never ending. • Required by BOP • CQI is a more positive process than QA and QC • Constantly striving for improvement in every facet • Many Models of CQI exist • Examples include: PDCA, FOCUS –PDCA, Six sigma... • Key concepts: Plan, design, measure, assess, improve Reimbursements and 3rd Party Payers • How we get paid (Slide 2) ○ Patients (Cash or Private pay) ▪ Can pay for the complete cost of the Rx ▪ Up to the Pharmacy to decide how much to charge ○ 3rd Party Payers (Insurance Co/Gov.) ▪ Pay for all or a large portion of the cost of a prescription possibly leaving a patient with copay ▪ Payment is based on a contracted rate