As payers and the public increasingly demand proof of value and improved outcomes, a philosophy of heightened accountability is taking hold in all sectors of health care. Performance measurement is the name of the game–and pharmacy needs to be a key player as the game heats up.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has already moved to raise the bar with ORYX, its initiative to make ongoing performance measurement an integral part of all JCAHO accreditation programs. Accredited long-term care pharmacies have not yet come under the purview of ORYX, but they will soon. Pharmacy providers must position themselves now for the ORYX challenge, while continuing to tackle existing accreditation challenges, including important shifts in JCAHO policy and an evolving survey process (see page 776).
In keeping with the philosophy of ongoing performance improvement already inherent in its accreditation standards and soon to be fully embodied by ORYX, the Joint Commission requires accredited pharmacies to demonstrate a firm commitment to ongoing staff training and competency assessment. ASCP has been a leader in defining new ways for pharmacists to meet those requirements. Involvement in formal credentialing programs (such as the one administered by the Commission for Certification in Geriatric Pharmacy) is one way; participation in certificate programs (such as the geriatrics-focused programs offered at the last two ASCP midyear conferences) is another.
ORYX is the centerpiece of JCAHO’s efforts to arrive at a more streamlined, efficient, meaningful survey process. It represents a carrot-and-stick approach to performance assessment. The stick is mandatory ORYX data reporting, which will entail significant retooling and substantial resources. The carrot is the wide array of benchmarking data and quality assurance tools that will stem from the continuous flow of performance data that ORYX will generate. Once they taste the carrot, pharmacy providers may view the stick in a more favorable light.
For hospitals and nursing facilities, ORYX is already a reality. JCAHO has endorsed more than 280 automated performance measurement systems with quality indicators specific to those settings. Now JCAHO is assessing various systems and quality indicators for potential use by pharmacy providers, and we need to be actively involved in that process. These new indicators will have applicability far beyond the context of ORYX: They’ll also be a vital link to increased consultant pharmacist involvement in managed care plans and prospective payment systems, so it’s critical that ASCP members spearhead their development and quickly incorporate them into routine use.
Before long, pharmacy providers will be held up to the ORYX yardstick. If they expect to measure up, they need to move now.
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