title: Conformity with Optimal Drug-Use Processes: Comparison between the Accreditation Canada Managing Medications Standards and the Hospital Pharmacy in Canada Report.
abstract: BACKGROUND
  A recent symposium on change management highlighted the relatively slow pace of change in the drug-use process. This study was undertaken to determine the degree of concordance between different sources that document levels of conformity with optimal drug-use processes.
  
  
  OBJECTIVE
  The primary objective was to compare aggregate national results from the Managing Medications Standards (MMS) of Accreditation Canada and results from the biennial Hospital Pharmacy in Canada survey. The secondary objective was to discuss any significant discrepancies between the 2 sources.
  
  
  METHODS
  In this retrospective cross-sectional study, attempts were made to pair each Accreditation Canada MMS criterion with specific results from the Hospital Pharmacy in Canada 2009/2010 Report. Average conformity per criterion from the 2010 Accreditation Canada on-site surveys was compared with conformity as documented in the Hospital Pharmacy in Canada 2009/2010 Report. A discrepancy ratio was calculated for each criterion, with ratios less than 0.80 or greater than 1.20 being considered significant.
  
  
  RESULTS
  Overall, 82 (61%) of 134 MMS criteria could be paired with results from the 2009/2010 Hospital Pharmacy in Canada survey. The average calculated discrepancy ratio (± standard deviation) between the 2 sets of results was 0.62 ± 0.29 (range 0.05 to 1.19). The average discrepancy ratios by domain were as follows: 0.49 for safely administering medications, 0.58 for accurately preparing and dispensing medications, 0.61 for working together to promote medication safety, 0.62 for carefully selecting and procuring medications, 0.69 for monitoring quality and achieving positive results, 0.71 for appropriately ordering medications and transcribing medication orders, and 0.76 for properly labelling and storing medications. For 59 criteria, there was a significant discrepancy between the 2010 MMS on-site surveys and the 2009/2010 Hospital Pharmacy in Canada survey.
  
  
  CONCLUSIONS
  Nearly two-thirds of the MMS criteria could be paired with results from the Hospital Pharmacy in Canada survey, but the average discrepancy ratio of 0.62 indicates substantial discrepancies in the data collected by these 2 methods. Further studies are required to explore the reasons for such discrepancies.
authors.affiliation: , DPharm, is a Research Assistant with the Pharmacy Practice Research Unit, Centre hospitalier universitaire Sainte-Justine, Montréal, Quebec. She is also a pharmacy intern at the Université Lyon, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Barthélémy
authors.affiliation: , BPharm, MSc, is Assistant Director of the Pharmacy Department and the Pharmacy Practice Research Unit, Centre hospitalier universitaire Sainte-Justine, Montréal, Quebec.
authors.forename: Denis
authors.initials: D
authors.lastname: Lebel
authors.affiliation: , BPharm, PharmD, is Director of the Pharmacy Department, Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Régis
authors.initials: R
authors.lastname: Vaillancourt
authors.affiliation: , BSc, MHA, is Director of Program Development with Accreditation Canada, Ottawa, Ontario.
authors.forename: Chris
authors.initials: C
authors.lastname: Niro
authors.affiliation: , BSc, MSc, CHE, is Manager of Policy and Research with Accreditation Canada, Ottawa, Ontario.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mitchell
authors.affiliation: , BPharm, MSc, is Director of the Pharmacy Department and the Pharmacy Practice Research Unit, Centre hospitalier universitaire Sainte-Justine, and Clinical Professor with the Faculty of Pharmacy, Université de Montréal, Montréal, Quebec.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bussières
keywords: accreditation; comparisons; pharmacy practice