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Pharmacy Quality Alliance

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PQA Quality Improvement Indicators

Quality Improvement Indicators Differ from Performance Measures

PQA’s mission is to improve the quality of medication management and use across health care settings with the goal of improving patients’ health through a collaborative process to develop and implement performance measures and recognize examples of exceptional pharmacy quality.

In order to accomplish this, PQA traditionally has developed medication performance measures. The measures have been adopted by government and quality organizations, health plans and pharmacies, and are used as part of pay-for-performance programs, fulfillment of contractual obligations, plan comparisons, research and public reporting. 

As the delivery system evolves, PQA members recognized the additional need for pharmacists, pharmacies, and provider organizations to measure the quality of internal processes and outcomes of care, but without the obligation for external reporting or comparison.  These metrics used internally and solely for quality improvement are Quality Improvement Indicators, and can become parts of Quality Improvement and Measurement Systems (QIMS).  

Key differences between Performance Measures and Quality Improvement Indicators are described below.

Performance Measures: 
  • Provide a benchmark, allowing for comparison across organizations or systems; 
  • Are often mandated by government programs or payers; 
  • Include pre-established criteria with no ability for any organization to modify the criteria; and 
  • Can be used for contract fulfillment, public reporting, and pay-for-performance programs. 

Quality Improvement Indicators:
  • Do not provide a benchmark; rather they are used within an organization to establish a baseline; 
  • Allow organizations to implement quality improvement strategies to shift their baseline; 
  • Are used to better understand the efficiency and outcomes of internal processes;
  • Are inherently more flexible, and can be applied to different populations over different time periods; 
  • Are not used for external comparisons, public reporting, or pay-for-performance programs; and 
  • May become performance measures when there is information to support full specification and standardization of each element of the metric. 

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