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Background: For a medication dispensing service to function with quality, continuous evaluation is required, which is why it is necessary to have reliable measurement tools that make it possible. Quality indicators can serve as tools for managing quality, as they are variables that directly or indirectly measure changes in a situation and help evaluate the progress made in addressing it. This article aims to determine the feasibility and reliability of a quality indicator system for a drug dispensing service for paediatric outpatients in two Mexican hospitals. Methods: A study of the development type of health systems and services at a microlevel was conducted from October 2020 to October 2021 in the pharmaceutical service of two Mexican hospitals. To determine the feasibility of the quality indicators, a retrospective evaluation was performed, which considered the indicators that could be calculated with the available information to be feasible. To determine reliability, an inter-observer agreement study (Kappa (κ)) was performed. Results: The feasibility analysis revealed that all five reference indicators related to the structure were feasible in both hospitals. In the Infantil of the Californias hospital, all six process indicators evaluated were feasible, whilst only one was found feasible in H+ Querétaro. As for outcome indicators, only one was feasible in the Infantil of the Californias hospital. The causes of non-feasibility in both hospitals were the non-documentation of the primary data related to the stages of the process and the lack of instruments to measure patient satisfaction. The reliability of the indicators showed little variability. Conclusion: Although not all indicators were feasible, solutions were proposed so that the 15 reference indicators could be used if an organization decided to do so. The reliability of the indicators was demonstrated, evidencing the importance of the data sheet as a tool to generate valid reliable measures.This article is part of the Hospital pharmacy, rational use of medicines and patient safety in Latin America Special Issue: https://www.drugsincontext.com/special_issues/hospital-pharmacy-rational-use-of-medicines-and-patient-safety-in-latin-america/.
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Introduction: The lack of standard operating procedures (SOPs) to provide health education to patients with diabetes means that this service is provided in a heterogeneous, isolated and intermittent manner, thus limiting quality. Objective: To validate a SOP to provide health education to diabetic patients using Delphi methodology and determining its efficacy in clinical practice by performing a pilot study. Methods: The SOP was designed from a theoretical analysis of the available literature; a participatory brainstorming technique was used to define the processes included in the SOP. The research was carried out at the Comprehensive Pharmaceutical Care Polyclinic of a Mexican Institute of Health Sciences, from August 2017 to March 2020. The pilot test was carried out on 15 outpatients with diabetes type 1 and 2. The validation was carried out by a panel of experts using Delphi methodology, the consensus among the experts was estimated by determining Kendall's coefficient of concordance. The practice clinical efficacy of the SOP was determined by a pilot study in 15 diabetic patients using process indicators. Results: The SOP was structured in nine sections with the process approach described in the ISO 9001:2008 standards. The criteria issued by the experts relating to content, records and data extraction tools allowed improvement of the SOP. The pilot test showed that health education, following the SOP, improved metabolic control, level of knowledge, therapeutic adherence and the attitudes of more than 80% of patients. Conclusions: The SOP designed and validated by experts was effective in educating patients with diabetes due to the high impact achieved with the intervention and incorporates indicators to guarantee the quality of the health service provided.
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OBJECTIVES: This article presents a methodological strategy to design and validate quality indicators for drug dispensing in a pediatric hospital. SETTING: The literature evaluation, design, and validation of indicators by experts were carried out from September 2017 to March 2018 in the pharmaceutical services of a pediatric hospital at the Autonomous University of the State of Hidalgo, Mexico. PRACTICE DESCRIPTION: The design and validation of quality indicators for dispensing allow the evaluation, planning, and follow-up of this activity. PRACTICE INNOVATION: The development of the indicators follows a holistic vision considering the relationship between the structure on which the pediatric dispensation is based, the involved processes, and the outcomes and provide a simple tool to improve the quality of the dispensing service. EVALUATION: A methodological investigation for the development of systems and health services in drug dispensing was performed. For the indicator's design, the Mexican standards for establishments dedicated to the sale and supply of drugs, the Good Dispensation Practices, and the Donabedian model were considered. The validation of such indicators was carried out using the Delphi method and the Torgerson mathematical model. RESULTS: Indicators of structure, process, and results were designed; of the 16 indicators designed, 15 reached the average score of greater than 3.5, and the percentage of experts who qualified each indicator in the highest categories was greater than 50%. CONCLUSION: The design of indicators guarantees the quality of the dispensing service and can be extrapolated to the pharmaceutical services of any pediatric hospital.
