A majority of the individuals who requested the EPIQ program were pharmacy faculty members. Other recipients included pharmacists and other healthcare professionals working in consulting, managed care, government, industry, and hospital settings. There is a need for quality improvement educational materials in several other settings as evident by the percentage of requests from individuals outside of academia. However, this conclusion is tentative as the respondents were asked to indicate only one affiliation or area of practice on the questionnaire and this may not have been the venue in which they intended to use the EPIQ program. For example, a pharmacist who identified industry as his work setting also may have been a clerkship preceptor for a college of pharmacy. On the other hand, some of the faculty members who requested the program also may have been preceptors and intended to use the EPIQ program inside and/or outside the traditional classroom setting.
The overall response rate was somewhat lower than desired (57%, 55/97). Several who requested the EPIQ program reported not receiving a CD (n = 7). Possible explanations include incorrect mailing addresses or CDs lost in the mail. Of those who received the EPIQ program, only 56% (27/48) had reviewed the contents. This percentage was not as high as expected considering that each recipient had requested the program. Investigators were unable to provide those who requested but did not receive a CD or had not yet reviewed it with additional time to review and evaluate the program because of the need to complete the study on schedule. Another reason that respondents cited for not viewing the EPIQ program was difficulty opening certain files or difficulty understanding the file organization. Improvements that will be made to address these problems on future versions of the program include providing text files in a word processing format that is compatible with more computer systems, organizing the files in a more user-friendly layout, and including a printed program guide to assist recipients with program navigation.
In general, those who reviewed EPIQ thought the materials were comprehensive and useful. This feedback helps the investigators assess the degree to which they achieved their goal of developing a quality improvement educational resource that could be used by pharmacy faculty members and others to educate pharmacy students, pharmacists, and other stakeholders about measuring, reporting, and improving quality in pharmacy practice.
Twelve (44%) of the 27 EPIQ program reviewers indicated that some resources would be needed to customize the program to meet their needs. The EPIQ program was designed as an adaptable tool so that users could better match the material to the learner population in a particular environment. However, the need for adaption might indicate that EPIQ developers should consider revising EPIQ to better meet end user needs. To identify specific areas for improvement, future studies will investigate why users perceived that revisions were needed.
Approximately 82% of reviewers indicated they had or were planning on using EPIQ program content in specific courses as part of their pharmacy management or medication safety curriculum or to teach pharmacy students at experiential sites. This means that some portion of the EPIQ program will be incorporated into pharmacy education at 22 different classroom or experiential sites. As mentioned earlier, the PQA, IOM, and AACP have recognized the need for a comprehensive educational program pertaining to pharmacy performance measures, reporting, and quality improvement. Dissemination of the EPIQ program at these 22 sites will help the pharmacy profession reach this goal, as few, if any, similar comprehensive pharmacy quality improvement programs exist. The results of a study to evaluate EPIQ implementation at 8 colleges of pharmacy may provide further insight into opportunities and challenges of EPIQ use. In addition, the EPIQ program is being adapted for an interprofessional health care provider audience and integrated into a master in public health (MPH) degree quality improvement track. Implementation of EPIQ within a medical education context also has been considered with at least one medical school planning to adapt EPIQ in an online format and to incorporate it into its required curriculum.
Barriers to use of the EPIQ program included having a job site outside the academic or pharmacy classroom setting; not interacting with students; not having an identified plan of where the content fit in their college or school's curriculum; and believing content was too in depth for their college or school's curricular needs. EPIQ developers can address these barriers by providing suggestions on how material can be shortened and used in courses other than a dedicated patient safety course. The investigators also could develop and disseminate a few overview lectures or better adapt the EPIQ program for non-classroom environments.
This study has some limitations. Because the investigators were concerned about acquiescent response bias, a graduate student not involved with development of the EPIQ program conducted data collection and analysis. Nonresponse bias was not examined and may have affected the results. Also, the questionnaire used was of limited scope and contained few questions. The purpose of this study was to get initial feedback about the EPIQ program. In future evaluations, an increased number of questions will be used to improve reliability and validity.