Many pharmacies are exploring the issue of accreditation. They wonder: What will it take? Will it be worth the time, effort, and investment?
These are valid questions, and we’ll attempt to answer them here.
What is accreditation?
Essentially, accreditation is a process whereby a professional association or non-governmental agency grants recognition for demonstrated ability to meet predetermined criteria for established standards. For pharmacies, this means that the accreditation process will verify that the pharmacy staff has the level of training, expertise, and competency necessary to perform patient care services and clinical case management. It will indicate that the practice can be differentiated from other pharmacies.
Why would a pharmacy want to be accredited?
The short answer is to follow the money.
Payer agreements may require accreditation in order for the pharmacy to participate in certain programs. Or, they may offer a financial incentive, such as a per claim “bump” for those pharmacies that are accredited. In the specialty realm, manufacturers may require a pharmacy be accredited in order to have access to limited-distribution medications and biological products.
Pharmacies may also use their accreditation as a way to set themselves apart from their competition when marketing themselves to patients. The equivalent of the Good Housekeeping Seal of Approval, accreditation can reassure patients that their pharmacy — and their pharmacist — have gone the extra mile and are fully prepared and capable of handling their care and information in a safe manner.
What does a pharmacy have to do?
Once a pharmacy team decides it wants to obtain accreditation, the leaders need to decide a couple of things:
- What type of accreditation to pursue:
- Community pharmacy
- Specialty pharmacy
- Medicare’s DMEPOS
- Which accreditation organization to engage:
Of these, the Joint Commission works primarily with care facilities, i.e., hospital-based pharmacies. The others all offer programs for both community and specialty pharmacies.
Having a selected an accrediting organization, the hard work now begins.
Pharmacies will need to be prepared to demonstrate how they will meet the standards criteria established by the accrediting entity. Standards are generally organized into four areas:
- Administration and pharmacy organization/management
- Pharmacy operations, including the physical environment
- Patient care programs and services
- Clinical case management and quality programs
The process starts with the submission of documentation, which could include a mission statement, financial information, business associate agreements, proof of staff training, credentialing and licensure, business continuity plans, and policies and procedures. Pharmacies will need to be sure they have policies and procedures that cover essentially every area of the business, from hiring and training, financial management, inventory management, fraud, waste and abuse programs, physical plant management, compliance with applicable rules and regulations, and information security, to patient care services, including prescription processing, dispensing, counseling, and all programs offered.
Upon receipt of all of the required documentation, the accreditors will begin their review. They will identify any areas requiring attention and remediation and notify the pharmacy of the gaps. This will generally occur before the site visit, allowing the pharmacy to make the needed changes to the documentation and ensure that staff is trained on the proper procedure. It is critical that staff be trained on all policies and procedures well in advance of the site visit.
The accreditor may or may not schedule an on-site visit, which will involve several people and take several days. During this second key step in the process, the review team will look to see that your policies and procedures are fully implemented. They will interview staff on specific aspects of their job and may also ask about general operational issues, such as patient confidentiality and emergency plans.
They may also ask staff to demonstrate their access to and knowledge of a specific policy and/or procedure. They’ll want to see that all licenses are current, and posted in view of the customer. They’ll likely inspect your handling and storage processes, especially those for products that must be maintained at a specific temperature (or within a certain range).
After the site visit, the accreditors will hopefully grant accreditation or identify those areas that require remediation before full accreditation can be granted. Once you’ve received that accreditation, you can begin to leverage the accomplishment to grow your business.
And then get ready to renew your accreditation in about three years!
Marsha K. Millonig, MBA, BPharm, is president and CEO of Catalyst Enterprises, LLC, and an Associate Fellow at the University of Minnesota College of Pharmacy’s Center for Leading Healthcare Change.