Quality Improvement tools to improve the safe use of high risk medicines – a theory based evaluation

Research output: Contribution to conferencePoster


The Scottish Patient Safety Programme - Pharmacy in Primary Care (SPSP-PPC) collaborative is a Quality Improvement (QI) initiative striving to improve patient safety within community pharmacy. One element of the collaborative has involved implementation of High Risk Medicine (HRM) Care Bundles (CBs) which focused on non-steroidal anti-inflammatories and warfarin. These were implemented in 27 pharmacies across four NHS regions by applying the Institute of Healthcare Improvements’ “Breakthrough Series Collaborative Model”. This study reports on (1) implementation of the HRM CBs and (2) application of the collaborative model.
Mixed-method evaluation involved questionnaires, semi-structured interviews, case studies, process mapping and documentary evidence. Analysis was informed by two theoretical frameworks: the Kirkpatrick Model to investigate impact of training delivered; and Proctor’s Taxonomy of Implementation Outcomes to understand the factors influencing implementation. 
The evaluation involved approximately 187 participants. The collaborative model was rated positively, provided networking opportunities and motivation to engage, yet further consideration of learning needs and how best to deliver the QI approach at scale requires attention. The CBs were considered acceptable, appropriate, feasible and compatible within community pharmacy practice. Adoption of QI methods was variable and risks to sustainability included lack of whole-team involvement in CB delivery. Significant variation of the CBs between NHS regions existed; posing challenges for further implementation, such as equality of patient care. 
The findings demonstrate capacity for community pharmacy to deliver safety-focused initiatives within a collaborative. Application of frameworks helped develop key recommendations informing strategic decision-making. Key issues are being taken forward through consolidation and further testing of the CBs, and resource development to facilitate whole-team engagement.
Original languageEnglish
Publication statusPublished - 16 Nov 2017
EventEuropean Drug Utilisation Research Group conference 2017 - Technology & Innovation Centre, Glasgow, United Kingdom
Duration: 15 Nov 201717 Nov 2017


ConferenceEuropean Drug Utilisation Research Group conference 2017
Abbreviated titleEuroDURG
Country/TerritoryUnited Kingdom


  • high risk medicines
  • Scottish Patient Safety Programme
  • patient safety


Dive into the research topics of 'Quality Improvement tools to improve the safe use of high risk medicines – a theory based evaluation'. Together they form a unique fingerprint.

Cite this