Many pharmacy practices embrace the concept of continuous improvement by adopting a quality system and conducting reviews. Others may simply own a set of procedures, with no system approach to include audit and review. Too many quality initiatives begin with great enthusiasm and subsequently dwindle in support when barriers and challenges present themselves.

Practice settings vary greatly, and a good exercise is to undertake a quality MOT. It is rather like a baseline audit to allow an understanding of the practice's approach to quality. The MOT is useful to develop a 'helicopter' view of your practice and establish if your quality approach is delivering high standards.

It is beyond the scope of this article to explore a quality implementation approach, but an MOT will help you to identify gaps in your quality system and/or establish what you need to do before implementing a quality system. The first 10 steps help to establish the gaps in your quality approach.

What needs to change and what resources are required to support the change are established at steps 11 and 12. In steps one to 10, it is essential to be honest about your practice's current quality approach in order to identify gaps. An MOT will help to keep you focused.