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After completing this chapter, the reader will be able to

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  • Explain the evolution of quality management in industry and health care.
  • Describe the processes used to assess and improve quality.
  • Define the role of the pharmacist in modern health care quality improvement initiatives.
  • Explain the role of The Joint Commission in health care quality.
  • Describe the basic principles behind continuous quality improvement, total quality management, and Six Sigma quality.
  • Describe the role of medication use evaluation as a component of an organization's quality improvement program.
  • Outline the general process of medication use evaluation.
  • Describe the role of pharmacists and other health professionals in the medication use evaluation process.
  • Discuss quality improvement techniques applied in drug information practice.

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  • Image not available. Increasing competition in the health care marketplace, decreasing dollars with which to treat patients, and greater access to the availability of medical information through media outlets and the Internet have served to increase the public's awareness about the need to be more actively involved in the management of their health. As a result, there is an increasing demand for quality health care services at more affordable costs.
  • Image not available. In more recent years, focus has shifted away from quality assurance and quality control to embrace a different discipline in the search for quality—total quality management (TQM). TQM takes a more investigative approach to identifying barriers to quality in the processes of providing goods or services.
  • Image not available. Six Sigma is a data-driven, statistical process designed to eliminate defects and improve quality to a level of near perfection (99.99966% defect-free or six sigma).
  • Image not available. Problems associated with quality in health care fall into one of three categories: overuse, underuse, and misuse. Overuse occurs when a service is provided but is not needed, and thus the risk of harm from that service outweighs the potential benefit. Underuse results when a needed service is unavailable or not provided. Misuse occurs when the correct service is provided so poorly that the full benefit is not seen.
  • Image not available. The application of quality management techniques in health care is not very different than in other industries. Strong leadership, an open mind, willingness to put past differences or processes behind, and most importantly, a willingness to improve the existing system are required to ensure that quality goals are met.
  • Image not available. Medication use evaluation (MUE) is often part of an organization's overall performance improvement program that uses definitions of safe and effective use of medications to assess components of the medication use process.
  • Image not available. MUEs must reflect the scope of care provided by the organization and focus on high-volume, high-risk, or problem-prone medication-related processes.
  • Image not available. Criteria used to conduct MUEs should be based on current standards of practice and supported by current literature. A multidisciplinary team should develop the criteria, and participation should be determined by the nature of the process under evaluation.
  • Image not available. When the data collected as part of the MUE indicate that actual care provided to patients does not meet the standard of performance outlined within the criteria, intervention ...

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