Theresa J. Schindel

Changing Pharmacy Practice: The Leadership Challenge

Pharmacists can provide high-quality accessible care that improves patient outcomes, however these beneficial services are not widely available to patients. The profession faces a challenge with re...

Cooperation in Pharmacy Education in Canada and the United States

Although the education of student pharmacists and the practice of pharmacy in Canada have many similarities with that in the United States, there also are differences. The planning of curricula in pharmacy education is of particular importance to the advancement of pharmacy in Canada because of significant changes in the scope of practice in several provinces, and in how community pharmacy is reimbursed for the services it can, or should, provide. Greater dialog between Canadian and American pharmacists has the potential not only to impact practice on both sides of the border but also to improve collaborations among Canadian and American pharmacy educators. This article provides background information and some suggestions on how to build partnerships in pharmacy education between Canada and the United States. Consortia-like arrangements have some particular promise, as does engaging border-states and provinces in regional meetings and other activities. By working together, Canadian and US pharmacy educators have the opportunity to implement the best of what each has to offer and to devise new and better ways to educate future and existing pharmacists.

Development and implementation of the compensation plan for pharmacy services in Alberta, Canada

OBJECTIVE To describe experiences with development and implementation of a compensation plan for pharmacy services delivered by pharmacists in community pharmacies. SETTING Community pharmacy practice in Alberta, Canada. PRACTICE DESCRIPTION Pharmacists in Alberta have one of the most progressive scopes of practice in North America. They have authority to prescribe drugs independently, administer drugs by injection, access electronic health records, and order laboratory tests. PRACTICE INNOVATION A publicly funded compensation plan for pharmacy services was implemented in 2012. Principles that guided development of the compensation plan aimed to 1) ensure payment for pharmacy services, 2) support pharmacists in using their full scope of practice, 3) enable the development of long-term relationships with patients, 4) facilitate expansion of services delivered by pharmacists, and 5) provide access to pharmacy services for all eligible Albertans. Services covered by the compensation plan include care planning, prescribing, and administering drugs by injection. EVALUATION The guiding principles were used to evaluate experiences with the compensation plan. RESULTS Claims for pharmacy services covered by the compensation plan increased from 30,000 per month in July 2012 to 170,000 per month in March 2016. From September 2015 to August 2016, 1226 pharmacies submitted claims for services provided by 3901 pharmacists. The number of pharmacists with authorization to prescribe and administer injections continued to increase following implementation of the plan. CONCLUSION Albertas experiences with the development and implementation of the compensation plan will be of interest to jurisdictions considering implementation of remunerated pharmacy services. The potential impact of the plan on health and economic outcomes, in addition to the value of the services as perceived by the public, patients, pharmacists, and other health care providers, should also be explored.

University-Based Continuing Education for Pharmacists

University-based continuing education (CE) fulfills an important role to support the professional development of pharmacists, advance the practice of pharmacy, and contribute to societal needs for research and healthcare services. Opportunities for pharmacists to engage in new models of patient care are numerous worldwide, particularly as pharmacists’ scope of practice has expanded. Approaches to CE have changed to address the changing needs of pharmacists and now include a variety of approaches to support development of knowledge and skills. There is emphasis on the learning process as well as the knowledge, with the introduction of the concept of continuing professional development (CPD). As institutions of research and education, universities are uniquely positioned to bridge the gap between academic and practice environments, providing opportunities for translation of knowledge to practice. The Faculty of Pharmacy and Pharmaceutical Sciences at the University of Alberta is a provider of CE in Alberta, Canada, where an expanded scope of pharmacy practice includes prescribing, administering injections, accessing electronic patient records, and ordering laboratory tests. In this paper, the Faculty offers views about future directions for CE, including the integration of CE with core faculty activities, expanding the audience for CE, areas of focus for learning, and partnerships. Finally, we hope to ignite dialogue with others in the profession about the role and function of university-based CE.

Survey of pharmacist prescribing practices in Alberta

PURPOSE Results of a survey to characterize pharmacist prescribing in the Canadian province of Alberta are reported. METHODS A cross-sectional survey of a random sample of pharmacists registered with the Alberta College of Pharmacists was conducted. The survey was developed in four stages, with evidence of reliability and construct validity compiled. Analysis of variance and chi-square testing were used to compare prescribing behaviors. RESULTS Three hundred fifty of 692 invited pharmacists (51%) completed the survey, with 76.9% and 11.1% indicating that they practiced in community and hospital settings, respectively, and 12.0% practicing in a consultant role (i.e., on a primary care team or in a long-term care setting). Overall, 93.4% of the pharmacists had prescribed. The most common practices were renewing prescriptions for continuity of therapy (92.3%), altering doses (74.3%), and substituting a medication due to a shortage (80.6%). Twenty-three pharmacists (6.6%) indicated that they did not prescribe because they were on an interprofessional team, had a consulting role, or preferred to fax physicians to request orders. Pharmacists with additional prescribing authorization (6.3% of the total survey population) were more likely to prescribe to adjust ongoing medications (63.6%) than to initiate a new medication (18.2%). CONCLUSION A survey showed that Alberta pharmacists prescribed in a manner that mirrored their practice environment. Compared with other groups, hospital and consultant pharmacists were more likely to adapt prescriptions, and community pharmacists were more likely to renew medications. Pharmacists in rural areas were prescribing most frequently.

Evaluation of a multi staged professional development course for practising pharmacists in anticoagulation management

Background  With the evolution of pharmacist prescriptive authority in Alberta, Canada, professional development courses need to impact change in daily practice. We designed a multi stage course targeting anticoagulation management with several components: (1) a print‐based course to develop foundational knowledge; (2) a 2‐day workshop; (3) a 3‐day experiential programme; (4) distance mentorship to practice site; and (5) two full‐day mentorship meetings.

Positioning pharmacists’ roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada

BackgroundA comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists’ roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences.MethodsPublicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists’ Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists’ roles were constructed in communications about the Compensation Plan.ResultsIn total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists’ changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists’ roles as: (1) expanding to include services such as medication management for chronic diseases, (2) contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3) collaborating with other health care team members. Pharmacists’ changing roles were positioned in alignment with the aims of primary health care.ConclusionsSocial positioning theory provides a useful lens to examine the dynamic and evolving roles of pharmacists. This study provides insight into how communications regarding the Compensation Plan in Alberta, Canada positioned pharmacists’ changing roles in the broader context of changes to primary health care delivery. Our findings may be useful for other jurisdictions considering implementation of remunerated clinical services provided by pharmacists.

Discourse Analysis of Adult and Workplace Learning in Nurse Jackie

Popular culture, particularly in the form of television, has a profound influence on understandings of the social world. Television is a source of information that not only shapes public perception (Cabaniss, 2011; Wright, 2010) but also creates a cultural space where adults can learn knowledge, attitudes, and behaviours through observing the relevant performances of others in various contexts (Brookfield, 1986; Jarvis & Burr, 2011; Jubas, 2013).

The informing nature of talk & text: Discourse analysis as a research approach in information science

In Information Science (IS), as well as other disciplines, discourse analysis has been used to extend the range of contextual data gathered using other research approaches. This form of textual analysis can enrich our understanding of complex information practices and contexts, particularly in relation to the ways that society and individuals construct understandings of various phenomena. However, not all discourse analysis approaches are the same; linguistic, Foucouldian, and psycho-social discourse analysis practices vary in their intent and their application. This panel will provide an overview of the discourse analysis methodology, including how the approach is conducted in various disciplines. By focusing on three projects by IS scholars that use discourse analysis, the range of data collection and analysis possibilities – including benefits and limitations of the approach – will be explored. The panel will also discuss how discourse analysis can be used in mixed methods studies, or with research participants engaged in other methods, to extend the research knowledge in the discipline.

Evaluating Pharmacists' Experience Using Diabetes Practice Tools: A Pilot Study

Abstract Background: Practice tools, such as patienthandouts, pocket cards, and documentationforms, can help pharmacists initiate practicechange and improve routine care provided topatients. In this project, 5 practice tools weredesigned to help pharmacists improve theirusual care of patients with diabetes. Methods:A group of practising pharmacists wasinvited to use the practice tools and report ontheir feasibility. Participants met with theresearchers, were introduced to the practicetools, and were asked to field-test the tools. Theywere encouraged to use each tool at least 3 times,and were asked to complete a tool report formeach time they used a tool.Results: Eight pharmacists, primarily from com-munity practice, tested the diabetes tools. Par-ticipants completed each tool report form atleast once, for a total of 51 reports. Participantstook an average of 6 minutes to use the tools.The longest mean time required to use a toolwas 9 minutes, and the shortest was 4 minutes.Participants indicated that they would use thetools again. In 76% of tool uses, participantsfound the tools “easy” or “very easy” to use. Formost tool uses, participants indicated that thepatient was receptive (77%) and the tool fulfilledits purpose (73%). When asked to rate theiroverall experience with the practice tools, mostparticipants (71%) strongly agreed that thesetools would help them communicate with theirpatients and they liked the fact that they couldphotocopy them. Conclusion: A select group of pharmacists werewilling to test diabetes practice tools in theirworkplace, and several continued to use themin their practice during the following year.When practice tools fit with pharmacists’ cur-rent roles, they are more likely to be used. Itmay be particularly challenging to help phar-macists use tools that support innovative andunfamiliar practices. Further research is neededto determine the use of tools in other practicesettings, the impact of tools on the manner inwhich pharmacists deliver patient care, the levelof pharmacist support needed to facilitate toolimplementation, and the impact of tool use onpatients’ economic, clinical, and humanisticoutcomes.