Community Pharmacy Accreditation: Good Idea?

Does community pharmacy need an accreditation program? If I practiced as a community pharmacist, I would probably say “No.” I know I am doing a good job, I would rationalize, so why would I need someone to evaluate what I do? My colleagues and my supervisors are already evaluating my work. I think that process is sufficient to assure that I am doing a good job. That’s how I might think to conclude that such a program is not needed.

After all, the cost of such a program would probably be significant. As we keep focusing on keeping health care costs down, why add something else that will only increase costs? Plus, there is no evidence that such a program is needed. And besides, our state board of pharmacy is there to intervene if a real problem exists.

I can certainly understand such thinking. No one wants more outside interference in our work—we have enough already. Yet I have come to realize that we don’t know what we don’t know. Often we get stuck thinking that “my way is the best and right way,” so we don’t change or make improvements when we should. Could an accreditation program serve as a tool to actually improve our performance? I think it might.

I started my career in hospital pharmacy when, in retrospect, hospital pharmacists were not providing very good service. Hospital pharmacists did their work, thinking they were meeting needs. They were often reluctant to change what they did and how they did it. Likewise, many hospital administrators and nursing departments didn’t want the pharmacist’s role to change either.

One tool that progressive hospital pharmacy directors used to promote change was the Joint Commission on Accreditation of Healthcare Organizations (JCAHO; now called the Joint Commission) accreditation standards. It’s my opinion that the hospital accreditation program played an important role in advancing hospital pharmacy practice. That’s not to say that the accreditation program makes life easier, but it was and still is a positive force to improve performance.

Thus, when I learned that the National Association of Boards of Pharmacy was participating with the American Pharmacists Association (APhA) to develop a voluntary community pharmacy accreditation program, I thought it would be a good step to advance community pharmacy services. Not everyone agrees.

The National Community Pharmacists Association (NCPA) has had an official position since 1998 to support individual state boards of pharmacy as the regulatory bodies for pharmacy rather than another entity providing national oversight. In his July 13, 2012, executive update, NCPA Chief Executive Officer Doug Hoey listed 10 different concerns that he and his organization had with a community pharmacy accreditation program.

The APhA published draft Community Pharmacy Practice Standards and asked for comments in the July 2012 issue of Pharmacy Today. My reading of these 5 standards suggests that meeting them would go a long way toward assuring a new practice model for community pharmacy, something I have been advocating for some time now.

The Center for Pharmacy Practice Accreditation Programs is an effort by APhA to allow community pharmacy and the pharmacy profession to control its own destiny. Another accreditation program is also being developed by a health care accreditation organization called URAC. I don’t believe we need 2 competing programs. Hopefully, a way will be found to coordinate these efforts. I opened this commentary by asking, “Does community pharmacy need an accreditation program?” I answer this important question with a “Yes.” What do you think?

Mr. Eckel is a professor emeritus at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He is past executive director of the North Carolina Association of Pharmacists.