North Dakota Board of Pharmacy Quality-Related Events – Errors and Continuous Quality Improvement

By Howard C. Anderson, Jr, RPh
The Board, at its July 18, 2013 meeting, voted to move ahead with a rule to require a continuous quality improvement (CQI) program in all North Dakota pharmacies.
The Board already has a requirement in all of its telepharma- cies, central sites, its hospitals, and for sterile product preparation.
ND Vol. 2, No. 4

Many states have mandated reporting of errors that cause mortality or significant morbidity. The North Dakota Board feels this is too late in the process, as harm has already occurred.
It is the intent of the new requirement to focus on quality- related events (QREs), which are the precursors of errors (those that get out of the pharmacy’s hands and put the patient at risk).
The rule will require recording of QREs and analysis of them to identify places where changes can be made to prevent errors from occurring. Errors are also reported and serious analysis (gap analysis) is conducted to determine why we have a gap between our expected outcome (a perfect prescription or more importantly, a good patient outcome) and what actually occurred (an error of some kind resulting in a poor patient outcome).
The rule will include discovery protection (a lawyer cannot ask for your CQI report so he or she can find potential clients or reveal that you had six near misses to bolster his or her case before the judge or jury).
The rule will include a reference to reporting to a patient safety organization (PSO) to provide federal protection under the 2005 Patient Safety and Quality Improvement Act.
The North Dakota Pharmacists Association has a co-marketing agreement with a PSO and an excellent online CQI program. The Board will also have manual QRE recording forms on its Web site should you not choose to utilize an online CQI program. The Board will ask you to analyze your internally recorded QREs in lieu of the computer-assisted analysis.
Look for the rule hearing announcement, and of course the proposed rule will be published. 

quoted from the North Dakota Board of Pharmacy September 2013 Newsletter

Vermont Board of Pharmacy Public Hearing Scheduled for October 2, 2013 Regarding Rule Changes

Board Public Hearing
The Board has recently completed a review of the Rules Governing the Practice of Pharmacy. The Board will hold a public hearing on the proposed rule amendments, additions, deletions, and corrections on October 2, 2013, as part of its regularly scheduled meeting. The meeting is open to all and the Board will take testimony – positive, neutral, or negative – on the proposed changes. All individuals working in the profes- sion as well as any other interested individuals are encouraged to review the proposed changes and comment accordingly.
For more information or if you have questions, please contact the Board office.

quoted from Vermont Board of Pharmacy September 2013 Newsletter 

New Law in Vermont Relating to Pharmacy-Act 75

New Laws for Vermont
In response to seemingly increased opioid addiction and methamphetamine abuse in the state, the 2013 Vermont Gen- eral Assembly passed and Governor Peter Shumlin signed Act 75. The act was formerly known as H.522 (House Bill 522).
There are several provisions that affect the practice of pharmacy and pharmacists in the state of Vermont. It is the responsibility of all pharmacists to be familiar with the law, conversant with it, and to abide by its provisions in the course of their practice of the profession.
All prescriptions for regulated drugs shall be made to the order of an individual patient, dated as of the day of issue, and signed by the prescriber. The prescription shall bear the full name, address, and date of birth of the patient. In the event the prescription is for an animal, the name and address of the owner of the animal and the species of the animal.
All prescriptions shall also bear the full name, address, and registry number of the prescriber. If the prescription is written, it shall be in ink, indelible pencil, or typewritten and shall be signed by the prescriber. A written prescription for a controlled substance (CS) shall contain the quantity of the drug written both in numeric and word form.
Only a patient for whom a prescription was written, the owner of an animal for which a prescription was written, or a bona fide representative of the patient or animal owner may pick up a prescription for a Schedule II, III, or IV CS. Prior to dispensing a Schedule II, III, or IV CS, a pharmacist shall require the individual receiving the drug to provide a signature and show valid and current government-issued photographic identification as evidence that the individual is the patient for whom the prescription was written, the owner of the ani- mal for which the prescription was written, or the bona fide representative of the patient or animal owner. If the patient does not have valid, current government-issued photographic identification, the pharmacist may request alternative evidence of the individual’s identity, as appropriate.
The legislation requires the Vermont Board of Pharmacy to adopt rules to define which persons shall be considered bona fide representatives of a patient. To that end, the Board has proposed the following rule definitions.

“Bona fide representative of a patient” as referred to in 18 V.S.A. §4201(26) means an individual who is authorized by law or known to the patient and authorized by the patient to receive drugs dispensed by prescription for the patient.
“Bona fide representative of an animal owner” as referred to in 18 V.S.A. §4201(26) means the owner of an animal or a person authorized by the owner to receive drugs dispensed by prescription for the animal.
“Alternative evidence of the individual’s identity” as referred to in 18 V.S.A. §4201(26) means documents that reasonably permit a pharmacist to conclude that the individual is who he or she purports to be.
The adoption of the aforementioned proposed definitions will be part of a public hearing the Board will hold on Wednes- day, October 2, 2013.
quoted from the Vermont Board of Pharmacy September 2013 Newsletter 

West Virginia Board of Pharmacy Sets Deadline for Out-Of-State Board Sets Deadline for Mail-Order Pharmacy PIC Licensure

As mentioned in the last issue, the legislature passed “The Larry W. Border Pharmacy Practice Act,” House Bill 2577, on April 13, 2013, setting an effective date of July 1, 2013. As it was going through toward passage, some noticed that the language would require every pharmacist practicing “pharma- cist care” in West Virginia to have a West Virginia pharmacist license. This is not a surprising concept, of course; that is, until people noticed that the language would require all out- of-state pharmacists dispensing from mail-order pharmacies into West Virginia to be licensed in this state, which would be a new burden if implemented. There are approximately 360 active mail-order permits issued by the West Virginia Board of Pharmacy, with the vast majority of those being out-of-state permits. So, the act was amended to provide that only the pharmacist-in-charge (PIC) of the out-of-state mail-order pharmacy would have to be licensed as a West Virginia pharmacist; the other pharmacists working under the PIC would simply need a valid pharmacist license in the state where the pharmacy is located. The Board noted that the PICs around the country would need some time to reciprocate their licenses to West Virginia. So, the Board voted to allow until July 1, 2014, for the out-of-state mail-order pharmacies and their PICs to become compliant. If you are one of those PICs, the Board looks forward to working with you through the licensing and reciprocation process in the coming weeks. 

quoted from the West Virginia Board of Pharmacy September 2013 Newsletter