Pharmacy departments are increasingly expected to demonstrate impact on patient care. But how should pharmacy leaders choose among the hundreds, if not thousands, of established quality measures to showcase that value?
A Dec. 7 session at the ASHP 2025 Midyear Clinical Meeting & Exhibition, Measure for Impact: Demonstrating Value of Pharmacy Services, discussed past, present, and future efforts to distill the “vast ocean” of available metrics to most meaningfully capture the pharmacy workforce’s contributions to healthcare. ASHP has two quality measurement initiatives to help position pharmacy departments for growth and sustainability in the current healthcare landscape.
“We have struggled as a profession to consistently and accurately monitor the work going on within pharmacy departments,” said Kayla Waldron, ASHP’s director of medication use and quality improvement. “Not only are these measures critical for broader reporting, but they're also important for benchmarking — and they’re what executives within our health systems are looking for.”
With the abundance of clinical, financial, and operational metrics in healthcare, it can be difficult to know where to start. Historically, pharmacy practice quality measures have been limited to either interventions or operational tasks rather than outcomes. When deciding what to measure, the presenters urged attendees to prioritize data points with a strong evidence base for helping patients. The ideal quality metrics are feasible to collect and fall within pharmacists’ purview — although not their full control, given the interdisciplinary nature of healthcare.
The session also encouraged pharmacists to consider their audience. Quality metrics must be easily understandable to non-pharmacy stakeholders. “We cannot walk into a C-suite with 50 measures for our collection of disease states, because then we just won’t be listened to,” Waldron said.
Curtis D. Collins, a pharmacy specialist in infectious diseases at Trinity Health Ann Arbor in Michigan, drew on his years of experience with the National Quality Forum, which until 2023 was the federal government’s preferred consensus-based entity for healthcare performance measurement. He described the ASHP Pharmacy Accountability Measures (PAM) work group, launched in 2014 to streamline medication outcomes and demonstrate pharmacy accountability through established quality measures. In its final 2025 recommendations, the PAM work group adopted 31 measures across seven clinical areas, from rates of hospital-onset Clostridioides difficile infections to glycemic control (HbA1C <8%) for patients with diabetes to initiation of adjuvant hormonal therapy for people with HR-positive breast cancer within one year of diagnosis.
It's not enough for pharmacists to be personally convinced about the value of a metric, Collins emphasized. The field must initiate research to fill any gaps in our understanding of which measures contribute most to therapy outcomes.
“If we feel it’s important as pharmacists to really continue to demonstrate value in terms of hard outcomes … we’ve got to do well-designed trials,” he said.
Waldron then introduced the audience to ASHP’s newest quality improvement initiative, Measure for Impact (M4I). Launched in fall 2024, M4I will build on and complement the PAM recommendations with a series of consensus-driven impact measures across five domains. Pharmacy teams can use the forthcoming M4I guidance to benchmark and align with the standards needed to be recognized as an ASHP Certified Center of Excellence™.
To reach consensus, the M4I initiative will take a methodical, validated approach that leverages environmental scans and literature reviews, plus iterative surveys of subject-matter experts. What sets the initiative apart is participation from experts across the healthcare ecosystem, in addition to ASHP members.
“We need to make sure that [the proposed measures] are not only relevant and consistent with practice, but also that they fit into the broader interdisciplinary framework,” Waldron explained. “While the majority of the individuals [on the panels] are pharmacists, we have brought in leaders from other health professions, such as administration, physicians, nursing leaders, and even other professional organizations, to weigh in.”
For its first domain, medication use and safety, M4I has developed a set of 22 measures that will soon become available for public comment before final endorsement by the M4I steering committee. Next up, ASHP will tackle the clinical care and quality domain, subdivided into acute care, ambulatory care, and oncology specialties.
Pharmacists’ push for value-based care will outlast any specific initiative or set of guidelines, the presenters noted. “This is not a one-pass thing,” Waldron said. “Measures constantly change as new ones become available, new data comes out, or things move out of favor. We can reactivate this consensus plan when we need to.”
