SERVICE OR PROGRAM: Measurement of fidelity, the extent to which an intervention is delivered as intended, is important to ensure quality and impact. As part of the Comprehensive Medication Management (CMM) Effectiveness and Implementation Grant, a multifaceted approach was used to measure fidelity to CMM, as defined by the common language of CMM. Fidelity of the CMM practice will be assessed using: (1) a biannually administered self-assessment, (2) a rubric to evaluate written clinical documentation, (3) a written or verbal clarification of elements not apparent in clinical documentation, (4) a practice management self-assessment, and (5) a patient responsiveness survey tool. Refinement and validation of the fidelity assessment system is ongoing. JUSTIFICATION/DOCUMENTATION: Development of this system was pursued to ensure fidelity to CMM and increase consistency in delivery of CMM by 50 pharmacists across 35 participating sites. Beyond the scope of this project, it was recognized that no such system exists and could be useful in the broader CMM practice and research communities. ADAPTABILITY: This system of fidelity assessment tools can be applied to future research and/or practitioner quality assurance, evaluation, and training. Individual assessments or groups of assessments can be applied depending on the aspect of practice of interest (e.g. practice management vs. patient care process). Individuals or practices as a whole may be assessed. SIGNIFICANCE: Fidelity is frequently overlooked in clinical research and/or often poorly described, making it difficult for clinicians and researchers to interpret the actual impact of interventions
and to compare findings across studies. No other CMM fidelity assessment system currently exists, and CMM fidelity has only been assessed in reported research in limited ways. A validated fidelity assessment system will be a valuable tool for future practice, training, quality improvement efforts, and research.