Analysis of quality indicators of pharmaceutical healthcare provided in in-patient healthcare institutions: Case study

Hospital pharmacy is a specialized field within pharmacy and an integral part of healthcare provided to hospitalized patients in a healthcare institution, striving to maintain and continuously improve medication management and pharmaceutical care for patients in line with the highest standards in a hospital environment. Purpose of the study was to monitor pharmaceutical healthcare quality indicators for in-hospital pharmacies, to explain the concept of quality and provide recommendations for the provision of pharmaceutical healthcare in secondary and tertiary healthcare institutions through pharmaceutical healthcare quality indicators. We used the case study method as an in-depth, intense and precisely focused method of descriptive research to present our three-case series. To analyse case studies, we selected hospital pharmacies in three healthcare institutions, the Clinical-Hospital Center (CHC) Zvezdara, University Clinical Center (UCC) Kragujevac and Special Hospital for Addiction Diseases (SHAD). Reference framework was established according to pharmaceutical healthcare quality indicators taken from a pilot project on quality indicators in hospital pharmacies entitled "Indicators of quality and patient safety in pharmaceutical healthcare - hospital pharmacy" from 2012. Data was collected from questionnaires that were filled in directly by pharmacists from pharmacy databases and records from regular everyday work activities. For the purposes of achieving second and third objectives of this study, we performed a literature search for the quality of pharmaceutical healthcare and quality indicators. Comparison of the calculated indicators from the 3 health care institutions presented in our case series provided insight into indicators that are monitored in all three healthcare institutions (6 indicators) as well as in the distribution of indicators by institutions encompassed by our research. Comparative analysis of the calculated indicators by healthcare institutions indicates that I1 is monitoring 12 indicators, I2 9 indicators and I3 8 indicators. Only 1 indicator from the pilot project is being monitored in line with the new "Rule-book on healthcare quality indicators and on the evaluation of the quality of professional work" in the observed institutions (adverse reactions to the medicines/medical devices). The same Rule-book imposes monitoring of another 4 indicators, pointing to improvement of the healthcare system and modernization of pharmaceutical healthcare. It can hence be concluded that the implementation of new indicators requires recommendations and that further research is necessary to determine how to assess pharmaceutical healthcare efficiency and quality that are to be improved through indicators introduced in the pharmaceutical healthcare practice.