Why is the College implementing the new Practice Review Program?
The College is implementing the Practice Review Program in order to enhance the quality of pharmacy practice by improving compliance through strengthened enforcement. One of the ways that the College can ensure best practices are being followed is to establish and communicate standards and guidelines to pharmacy professionals and review their individual performance in a pharmacy setting. By reviewing real practice in real time, the College is helping to maintain and elevate public confidence in the profession.
Who has been involved with the development of the Practice Review Program?
The Board has consulted widely on the program, and was actively informed not only by the Quality Assurance Committee, but by the 1500 practising pharmacy professionals across the province who participated in an online engagement opportunity. Pharmacy managers and pharmacy professionals in community pharmacy practice also participated in two feedback forums held in April 2014.
At the April 2014 meeting, the Board established the Practice Review Committee which will oversee the development of the program, and its policies and processes for final approval by the Board.
How will the Practice Review Program work?
The Practice Review Program will have two components: the Pharmacy Review and the Pharmacy Professionals Review. The Pharmacy Review component will be a familiar process, as it mirrors the College’s current pharmacy inspection process. For the Pharmacy Professionals Review, a College compliance officer will observe and assess individual pharmacy professionals in four key areas of practice. Compliance officers will ensure that pharmacies meet College standards/guidelines and that pharmacy professionals are appropriately applying their knowledge, skills, and abilities to deliver consistent pharmacy care.
With the new program, pharmacy managers and pharmacy professionals will receive advance notice of a Practice Review and will know what will be reviewed. Pharmacy managers and professionals will also receive their results once the review is completed.
How will scheduling work?
Every pharmacy will be reviewed cyclically on a multi-year time frame. The College will be looking at a number of factors when scheduling reviews.
The College will confirm a date for the Practice Review with feedback from the pharmacy manager. It is the pharmacy manager’s responsibility to ensure that their staff are available during the scheduled Practice Review.
With over 1200 community pharmacies and 3700 community pharmacy professionals in the province, scheduling will be challenging but it will be achievable with your help.
What if there are scheduling conflicts for staff who are sick or on holidays?
The College understands that at certain times of the month or year it may be inconvenient to have compliance officers in pharmacies for an extended period of time. The College will do its best to work with the pharmacy manager to determine the least disruptive times, but it is the pharmacy manager’s responsibility to ensure that most, if not all, staff are present during the Practice Review.
In the event where pharmacy professionals miss the Practice Review, a compliance officer will return to the pharmacy to perform those reviews.
What is the College looking for during the Pharmacy Review?
Compliance officers will be reviewing pharmacies for adherence to practice standards and guidelines such as the Health Professions Act, College Bylaws, the Model Standards of Practice, the Pharmacy Operations and Drug Scheduling Act, Professional Practice Policies, and the Framework of Professional Practice and guidelines
What is the College looking for during the Pharmacy Professionals Review?
Pharmacy professionals will be reviewed on focus areas that have been deemed the most relevant to professional pharmacy practice in British Columbia. The Board has identified a total of six focus areas they believe to have the greatest impact on public safety. Focus areas differ between pharmacists and pharmacy technicians. Each will be reviewed on four focus areas depending on their registration type:
The focus areas for pharmacists are:
- Patient Identification Verification
- Profile Check
The focus areas for pharmacy technicians are:
- Patient Identification Verification
- Product Distribution
What happens after the review has been completed?
After the review has been completed, the compliance officer will forward the Pharmacy Review results to the pharmacy manager, and individual Pharmacy Professional Review results to each pharmacy professional. These results will be available in real time, accessible online through the confidential and secure eServices portal. The compliance officer will discuss results with the pharmacy manager and individual pharmacy professional for their respective reviews.
Where a compliance officer observes a standard/guideline that is not met, they may assign action item(s). These observations and action items are standardized to ensure consistency and fairness of all practice reviews. Pharmacies and pharmacy professionals will be given deadlines (typically 30 days) to complete these items, and compliance officers will verify whether the action items have been completed by the deadline. After all action items have been completed, the compliance officer will sign-off on the review, and a notice of completion will be issued to the appropriate party.
When is the Practice Review Program being launched?
The Practice Review Program launched in Community Practice in 2015 and in Hospital Practice in 2017.
How will pharmacy professionals who do not practice in a conventional community or hospital setting be reviewed?
The College recognizes that there are a variety of different practices in BC, and asked for feedback on this subject through online engagement with over 1500 pharmacy professionals. The College will be taking a phased approach in developing the Practice Review Program and, with input from the Practice Review Committee, will develop processes that address different practices within the province.
Are e-signatures an acceptable form of prescriber authorization?
An electronic prescriber’s signature is only acceptable if the signature is unique. Health Canada considers a unique electronic signature to be equivalent to a paper-and-pen signature. It must be a fresh, new signature written on the prescription with an electronic pen pad, similar to signing a pen to paper prescription. It is an illegal electronic signature if it is cut and pasted into an electronic prescription.
To ensure the signature is unique, the pharmacist should compare the signature each time with an old prescription. The signatures should be slightly different if they are unique, as is an original signature each time.
If you don’t have an old signature with which to compare the current signature, please call the prescriber to determine if a new, original electronic signature is generated for each new prescription.
A computer-generated prescription that is given to the patient or faxed to the pharmacy must have an original prescriber’s signature or a unique electronic signature.
What criteria or specific details will the College be looking for under each of these four focus areas?
For information on specific assessment criteria, please refer to the following review forms:
For Hospital Pharmacy:
- Hospital Pharmacy Review Form
- Hospital Pharmacist Review Form
- Hospital Pharmacy Technician Review Form
For Community Pharmacy: