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Culture of Safety

Overview of Just Culture

Culture of Safety Overview

The Board continues to move forward with its plans to increase focus on developing a “culture of safety” or “Just Culture” approach to the practice of pharmacy in Idaho.

A survey was conducted in late summer 2019, which has assisted in bench-marking the current state of practice for a few key markers. The results can determine a baseline to improve best practices. A total of 351 pharmacies across the state were surveyed and ranged from community pharmacies, including chain drugstores and independent outlets, to hospital inpatient settings and limited service operations.

The questions asked ranged from medication safety incident reporting and accuracy checkpoints to electronic verification/dispensing and pharmacist prescribing capabilities. Below are some of the most interesting findings from the survey.

Medication Safety Incident Reporting

Nearly all pharmacies report medication safety incidents in house but only half report to a patient safety organization (PSO); independent stores report the lowest usage. Participation in PSOs may allow pooling of medication safety incidents reporting to a much larger network of operations, and better facilitate learning from each other and avoiding medication safety incidents that others may have experienced.

Use of Automation

Additional findings revealed that, in general, more independent stores reported the use of automation such as various types of counting machines, robots, and dispensing machines. Northern Idaho had the most pronounced difference when compared to chain stores in the same region of the State.

Pharmacist Prescribing

The survey also collected information related to pharmacist independent prescribing. Statewide, it was more common for chain drugstores to report prescribing. By region, northern Idaho was much less likely to report pharmacist prescribing even in the chain drugstores.

In addition, when looking at the protocols in use, chain stores had a much more varied array of conditions for prescribing. However, it appeared that independent stores reported a higher rate of prescribing for immunizations.

Culture of Safety Uses

These findings provide de-identified benchmarking, indicating the areas of operations that pharmacies might consider altering to achieve the standard of care. They also inform the Board of areas where education can be used as a strategy in Idaho pharmacies and across the spectrum of the industry to become safer and better able to assist with the health care needs of all Idahoans.

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