engleski

Quality indicators report pharmacy system strengthening in Federation of Bosnia and Herzegovina (FBiH) in COVID-19 response

Indicators are tools designed for and used in healthcare systems to monitor the state of safety and quality of measured aspects of healthcare provision. They serve as feedback for management and policy makers on the state and measure of priority topics and provide comparable and actionable information on where improvement is needed and what can be done. The value of an indicator provides comparable and actionable information across different geographic, organizational, or administrative boundaries and/or can track progress over time. Indicators are divided into three sub-groups: process, structure, and outcome. Purpose To monitor and improve the safety and quality of healthcare services provided in community pharmacies, Agency for Healthcare Quality and Accreditation in FBiH (AKAZ) defined five indicators for pharmacies in 2015. The pharmacies are to collect the needed data over the year, calculate the value of indicators, and report it to AKAZ once a year. AKAZ collects the reports, calculates the average indicator value for the pharmacies in the Federation of Bosnia and Herzegovina (FBiH), and publishes its report on the website. The indicators' values for pre- pandemic year of 2019 and two pandemic years 2020 and 2021 were observed. Method The defined indicators are to be collected and calculated for the previous year, January to December, and reported to AKAZ until March in the current year accordingly. During the COVID-19 pandemic, one indicator, the contact with MD for prescription clarification, had a significant increase. The mentioned indicator is calculated as a fraction of the number of times the pharmacist contacted a doctor, divided by the sum of all prescriptions in one year. Results The indicator values are compared for the pre- pandemic year, 2019, and for two pandemic years, 2020 and 2021. The result is expressed as an absolute number of yearly contacts and as a percent of prescriptions that needed clarification. The average indicator value for pharmacies in FBiH shows an increase in pandemic years. Pharmacists conntacted MDs over 15% more comapred to pre-pandemic year. Also, higher indicator values were reported for rural compared to urban areas. Conclusions Observing the reported data for last three years (2019, 2020 and 2021), the results derived from indicator values are significantly affected by the COVID-19 response. COVID-19 and the associated health response impacted many of the indicators reported and explained much on reported improvements or reductions in the previous period. Being easier accessible than all other healthcare providers, the pharmacists also had to bear more workload developing local solutions to local problems, emphasizing continuous improvement at a local level to lift overall health system performance.

quality indicators ; pharmacy ; FB&H

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