The Clinical Oncology Society of Australia (COSA) Guidelines for the Safe Prescribing, Dispensing and Administration of Systemic Cancer Therapy define national best practice in the safe provision of cancer therapies. Our state-wide pharmacy service sought to assess current cancer pharmacy practice against these guidelines, to identify strengths of current practice and areas for improvement across the organisation.
A panel of cancer pharmacists identified recommendations within the guidelines relevant to cancer pharmacy practice. For each recommendation, one or more quality measures were developed for assessment. Over 200 measures were established and used to develop a self-assessment audit tool. Senior pharmacists representing each metropolitan and regional Health Network indicated the degree of compliance with each measure for their service, utilising the response criteria from the Institute for Safe Medication Practices Medication Safety Self-Assessment. The results were reviewed by cancer pharmacists, a project pharmacist and senior management to determine organisational priorities.
The review demonstrated our state-wide pharmacy service largely provides safe and high-quality medication management in cancer care, however inconsistencies in the delivery of the range of cancer pharmacy services exist. Governance reform and a range of system improvements are required to achieve consistency and full compliance with best practice. Nine key recommendations were made to improve the quality and standardisation of cancer pharmacy services and ensure a trained and sustainable cancer pharmacy workforce into the future. These recommendations relate to workforce, teaching and training, service provision, governance and safety, quality, and risk.
The development of an audit tool to self-assess our state-wide pharmacy service against the COSA guidelines has successfully driven the development of a strategic quality improvement plan for cancer pharmacy in South Australia. Our pilot may provide a template for other organisations to self-assess their services against national practice guidelines and drive quality in their cancer pharmacy services.