From Workflow Integration to Patient Outcomes: The Expanding Role of PQIs

Pharmacy Times® interviewed Ginger Blackmon, PharmD, associate director of clinical initiatives at NCODA, on her presentation titled “NCODA PQI in Actions: Practical Strategies to Transform Oncology Care” at the NCODA Spring Forum in Denver, Colorado.

In the interview, Blackmon discusses how NCODA’s Positive Quality Interventions (PQIs) offer concise, evidence-based clinical guidance to standardize best practices in oncology pharmacy and enhance interdisciplinary care. She explains that PQIs are easily integrated into clinical workflows, support proactive management of treatment-related toxicities, streamline payer processes, and serve as tools for quality improvement. Looking ahead, NCODA plans to expand PQIs with new categories, including those focused on biomarker testing and pharmacy technician perspectives, while improving usability and accessibility.

Pharmacy Times: How do NCODA’s PQIs help standardize best practices in oncology pharmacy?

Ginger Blackmon, PharmD: NCODA’s PQIs are concise, peer reviewed clinical guidance resources that help standardize best practices in oncology pharmacy. They provide clear quality standards and practical recommendations for managing oral and now IV oncolytics. They support the multidisciplinary care team in delivering consistent, high quality patient centered care. And they're created by practitioners, so mainly right now by physicians and pharmacists, and they are for practitioners.

Pharmacy Times: How can oncology pharmacists integrate PQIs into daily clinical workflows to enhance medication management?

Blackmon: So, oncology pharmacists can integrate the PQIs into their daily workflow by incorporating the clear actionable steps that are outlined in the PQI process section. So, every PQIs divided into sections, and there is a process that really outlines those actionable steps. Each PQI is a bit different, but they're designed to be easily implemented. So, we have practices who do this through EMR care plan builds. Some use their pharmacy software, and some use them for team education on their processes.

Pharmacy Times: What role do PQls play in reducing treatment-related toxicities?

Blackmon: So, they play an important role here by equipping the care team with clear, evidence-based strategies for proactive medication management. They outline potential adverse events in advance and then provide guidance. And again, it's that real-world guidance from other practitioners on what works and on how to manage them, including patient education strategies, and this supports earlier intervention and hopefully patients staying on therapy longer.

Pharmacy Times: How do PQls support interdisciplinary collaboration among pharmacists, oncologists, and nurses?

Blackmon: At NCODA, we love the multidisciplinary team, and so many of our resources are geared towards the entire team, but the PQI promotes this collaboration by providing clear, shared guidance that can be used by the entire team. They may include something for the pharmacist who's reviewing dosing, or a nurse who's monitoring for side effects, the physician who's making treatment decisions, and they ensure everyone is aligned around the same practices, and streamline the communication of the team.

Pharmacy Times: What data or metrics can be used to measure the effectiveness of PQl implementation in oncology pharmacy practice?

Blackmon: So, the effectiveness of the PQI implementation can be measured in several ways. Depending on the specific intervention, this may look a little different from case to case, but metrics could include treatment duration, adherence rates, or timely patient education. We have some practices that use PQIs as a foundation for quality improvement projects, so they're developing plans around the intervention, and then they're tracking the outcomes and adjusting their workflows based on what they find, and hopefully, again, improving care for patients.

Pharmacy Times: What training or resources are available for pharmacists looking to implement NCODA PQIs in their practice?

Blackmon: PQIs in action articles, like the ones being presented at Spring Forum, offer real world insights into how practices are accomplishing the steps of the PQIs from the perspective of the multidisciplinary team. So, in these articles, we interview 2 to 3 practices. We try to have the physician involved, some advanced practice providers, the pharmacist, pharmacy technician, [and] nurses. [Ee] really try to engage every role. And the stories allow others to learn from their peer experiences and apply those lessons in their own workflows. NCODA’s international monthly webinars also frequently feature PQIs and PQIs in action articles, and share practice practical strategies from our members on those segments as well.

Pharmacy Times: How can PQls help streamline prior authorization and payer approval processes for oncology therapies?

Blackmon: PQIs can support prior authorization and payer approval by providing clear, evidence-based clinical information. It can be referenced in the process of completing that prior authorization. So many PQIs include details on indication, dosing, monitoring—all of these align with payer requirements. Many of the PQIs also contain a link to NCODA’s financial assistance tool, and this tool helps practices identify support resources and can make the entire access and approval process more efficient, and again, is patient centered.

Pharmacy Times: What future developments in PQI implementation are anticipated, and how might they further transform oncology pharmacy care?

Blackmon: Yes. So, I love this question because I think we have a lot of exciting things coming up at NCODA where PQIs are concerned. They've been around for 10 years, since we started, but we're excited about developments in their implementation.

So, a dedicated category of PQIs focusing on testing is in progress. It'll help support biomarker-driven care. And then we are also developing PQIs created by pharmacy technicians that will be for pharmacy technicians really addressing key operational issues from a text perspective.

We're also working toward a more streamlined PQI format to improve usability and continuing to expand the library to reflect emerging therapies and needs. And later this year, which I'm super excited about, we plan to launch a refresh version of the PQI in action, so hopefully the enhancements will make it more accessible, actionable, and aligned with evolving clinical practice.