Skip to Main Content

This book is the culmination of many years of academic study and real-world experience of the authors and those who have shaped our view of the world. For too long, the profession of pharmacy has functioned on the premise that quality depended solely on hiring good people who would naturally "do the right thing." We hope to shift the perspective of pharmacists and pharmacy students toward systems thinking wherein it is not enough merely to have good intentions. We need to understand how pharmacists interact with the system in which they work and how we can construct the system to safeguard our patients from human fallibility.

We also hope to fill the void in pharmacy curricula pertaining to quality and safety. Many pharmacists have received no formal instruction in the principles or tools of health care quality. This book provides information about the broad principles of quality improvement (QI) along with insights on their application to the practice of pharmacy. It also shows practical tools for QI that the reader can adapt to his or her specific needs.

Chapters 1–4 describe the current and future landscape for health care quality and provide a framework for examining standards of medication use . These chapters also establish the business case for QI and value-driven health care. There are clear consequences for ignoring the safety and quality deficits in our current medication-use system and we hope to establish the need for QI in the everyday practice of pharmacy.

Chapters 5–8 lay the foundation for understanding the concepts and tools of QI. The foundation is built on the theoretical frameworks proposed by quality gurus such as W. Edwards Deming, Walter Shewart, and Avedis Donabedian. We believe that it is important for pharmacists to understand how to think about quality so they can truly build the culture that is necessary for optimizing the safety and quality of our pharmacies and other health care organizations. In addition, these chapters outline key tools that are crucial to identification of problems, assessment of problems, refinement of systems, and continuous evaluation of quality.

Chapters 9–11 further examine methods for measuring safety and quality, including mechanisms for gathering consumer feedback on pharmacy quality. As with the other chapters, the authors seek to apply well-established measurement frameworks to the contemporary practice of pharmacy. The chapter on consumer feedback describes the development, testing, and potential uses of a survey that was sponsored by the Pharmacy Quality Alliance; the survey is modeled after the oft-used CAHPS measures throughout other sectors of health care. Finally, in Chapter 11, Kenneth Baker provides insights on how to integrate QI concepts and tools into a robust risk-management program.

Chapters 12–15 offer guidance on implementing changes that improve safety and quality. This part of the book includes discussion of how financial incentives and public reports on pharmacy quality may stimulate greater adoption of QI programs, and how effective teamwork and leadership can make these programs more effective. Chapters 16 and 17 then provide case studies and examples for implementing highly effective QI programs.

We believe that this book will be useful to practicing pharmacists as well as to pharmacy students. To assist pharmacy educators, we have developed a companion set of lectures and exercises that mirror the content of this book. This academic toolkit is known as Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) and is available from the Pharmacy Quality Alliance, Inc (

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.