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Pharmacists' Role Acknowledged in NQF Safe Practices

Donna Young

The critical role pharmacists play in improving patient safety and reducing adverse events was recognized by government and health care groups Friday when the National Quality Forum (NQF), a public–private partnership created in 1999, approved a health care "safe practice" stating that pharmacists should actively participate in all phases of the medication-use process.

NQF’s set of 30 approved safe practices should be universally used by health care organizations to "reduce the risk of harm resulting from processes, systems, or environments of care," according to the 190-member organization that includes consumer groups, employers, insurers, health care providers, and government agencies.

Kasey K. Thompson, director of the ASHP Center on Patient Safety, said that NQF’s specific acknowledgment of pharmacists in an approved safe practice is a "broad endorsement that pharmacists have a defined, unique expertise in medication use."

NQF’s approval of the safe practice could have broad implications for pharmacy, Thompson said, because the Centers for Medicare & Medicaid Services may adopt the entire set of approved safe practices as a condition of participation for health care organizations that receive government funding from the agency. But, he added, there is no guarantee that the agency will adopt the safe practices.

The safe practice pertaining to pharmacists underwent several revisions before Friday’s approval, Thompson said.

Some physician and hospital groups had opposed earlier drafts, arguing that it was unnecessary to explicitly call for the inclusion of pharmacists in all stages of the medication-use process, Thompson said.

Some of the groups had misinterpreted the safe practice as stating that pharmacists should be involving in prescribing and ordering medications for patients, he said. Other groups were concerned that hospitals, in the midst of a pharmacist work-force shortage, would be required to hire more clinical pharmacists to meet the safe practice if adopted as a standard by a regulatory or accrediting agency.

ASHP advocated retaining the safe practice on pharmacists in the medication-use process, Thompson said, and actively worked with the opposing groups in shaping the final version before NQF’s board voted on the measure.

"It would have been lost had we not stepped in," he said.

ASHP Executive Vice President Henri R. Manasse Jr. cochairs NQF’s Safe Practices Steering Committee.

Darryl S. Rich, associate director of surveyor management and development for the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), said that NQF’s pharmacist-specific safe practice is consistent with his group's medication management standards, which are scheduled for release in September as part of the 2004 Comprehensive Accreditation Manual for Hospitals.

JCAHO reviewed NQF’s draft safe practices when developing the medication management standards, Rich said.

JCAHO, he noted, is not using NQF’s safe practices as part of the accreditation survey process.

"We are surveying against our own national patient safety goals," he said.