APRIL 2014 - Nova Scotia's SafetyNET-Rx program, funded in part by Canadian Foundation for Pharmacy (CFP), is making its mark in the increasingly critical area of continuous quality improvement (CQI) in community pharmacy. "Nova Scotia is certainly a North American leader in CQI processes in community pharmacies and based on its success a number of other provinces are starting to ramp up," says Todd Boyle, an Associate Professor at St. Francis Xavier University in Nova Scotia who was part of the interdisciplinary team that worked with the Nova Scotia College of Pharmacists (NSCP) and the Institute for Safe Medication Practices (ISMP) Canada to develop SafetyNET-Rx. Boyle also holds the position of Canada Research Chair in Quality Assurance in Community Pharmacy at the Gerald Schwartz School of Business.
SafetyNET-Rx was established through an extensive pilot project with grassroots pharmacists, after which it received $48,000 from CFP's Innovation Fund in 2010 to develop manuals and standardized tools. "CFP's support allowed us to prepare training and support material critical for community pharmacies and other jurisdictions adopting SafetyNET-Rx," says Boyle.
The Saskatchewan College of Pharmacists is the first to do so. It launched its COMPASS (Community Pharmacists Advancing Safety in Saskatchewan) pilot project in the fall of 2013, using SafetyNET-Rx as its own "compass" to guide implementation. "SafetyNET-Rx has done all the groundwork," says Jeannette Sandiford, field officer at the College. "Nova Scotia has also had proven success using SafetyNET's tools, so it became fairly evident that we wanted to go in that direction."
In 2011 Nova Scotia became the first province to regulate CQI in community pharmacy by establishing standards of practice that included a requirement that community pharmacies annually self-assess the safety of the pharmacy's practices and hold quarterly staff meetings for CQI; it also requires pharmacists to report quality-related events, such as medication errors, to an independent body. As a member of the SafetyNET-Rx research team, the College worked with ISMP to develop an anonymous reporting tool (CphIR) that feeds into ISMP's national database.
"Before pharmacists implement the process they tend to say it's too overwhelming and that they don't have the time," says Beverley Zwicker, Deputy Registrar at NSCP. "But once they're engaged and have a system in place they often become its champion. This is a valuable upstream activity that will save time by reducing the number of prescriptions that need to be redone before they are dispensed, and more importantly it improves the quality and safety of the pharmacy's practice."
The need for CQI grows with the expansion of pharmacists' scope of practice, adds Boyle. "Injections and renewals and other authorities are wonderful, but they also result in new processes and new activities that have the potential to increase the likelihood of errors." Programs such as SafetyNET-Rx help pharmacists expand their scope of practice while ensuring that quality and patient safety remain at the forefront.
