Accp White Paper (original) (raw)

During the past several years, the emphasis on quality in health care has been evolving. Alongside this evolution of change has been the advancement of clinical pharmacy services in ambulatory care settings. Although they share importance, both health care quality and ambulatory clinical pharmacy services have progressed and moved in their own directions. Nevertheless, in today's evolving health care landscape, collaboration among providers, including pharmacists, must occur to enhance quality. Pharmacy services must improve quality to be a sustainable health care service. This paper provides a rationale and structure that tie health care quality and ambulatory clinical pharmacy services. By applying national principles of quality measurement, this paper proposes five tenets to consider when developing measures for clinical pharmacy services in the ambulatory care setting: (1) comprehensive, (2) accountable, (3) scientifically sound, (4) feasible, and (5) usable. Definitions of each tenet are presented. The paper uses exemplary literature on ambulatory clinical pharmacy services including diabetes, dyslipidemia, chronic lung disease, hypertension, anticoagulation, and heart failure to provide a context for the tenets and a discussion of their use. The paper also describes issues pertaining to health care quality and related costs using similar exemplary literature. Finally, a discussion is presented on both the opportunities and the challenges of measuring quality for ambulatory clinical pharmacy services. Issues related to the tenets, including shared accountability for health care quality, availability of comprehensive data to assess quality outcomes, feasibility of collecting and reporting quality, and need for additional rigorous scientific evaluation of ambulatory clinical pharmacy services, are described.