Module 11: The Best of Times; The Worst of Times Flashcards
Studies by Tsao et al. (2016, 2020) indicated the majority of Canadian pharmacists believed their work environment supported safe and effective patient care (pre-pandemic). However, most were dissatisfied with what? (3)
- The lack of break time for lunch
- Staffing levels
- The time allowed to complete tasks
What effects did the pandemic have on working conditions and challenges in pharmacy? (5)
- Reduced staffing
- Longer hours
- Drug shortages
- Covid-19 screening and vaccinations
- As many physicians elected to work remotely, pharmacists had more difficulty communicating with them in seeking to provide quality care.
- Limited access to physicians also meant pharmacists had to play a larger role helping patients manage their chronic diseases
What was a silver lining of the pandemic for pharmacies?
This “stepping up” by pharmacists led to a recognition among governments, patients, and others of pharmacy’s untapped potential to contribute to patient care.
- The (sometimes temporary) expansion of scopes of practice further increased the ability of pharmacists to effectively manage the care of their patients, especially within primary care.
- As a result, the health care system benefitted greatly from this historically underutilized health care resource.
The stress of added workload and new duties was exacerbated by:
A lack of recognition for pharmacists’ critical role during the pandemic
- Not considered for early access to vaccine nor provided timely information about changes in Covid-19 protocols
The patient-pharmacist relationship also experienced strain during the pandemic. Example?
Drug and PPE shortages and subsequent concerns with access and costs due to restrictions around quantities dispensed (30 vs. 100-day supply), and higher prices for PPE and other high demand items
How did problems seen in the pandemic persist over post-pandemic? (2)
- Staffing shortages in pharmacies brought on by the pandemic persisted post-pandemic, due in part to many, exhausted by the experience, choosing to leave practice.
- Low staffing levels also due to the business decisions of pharmacy ownership. - Pressure to do more with less:
- Heavy dispensing workloads along with pressure (quotas) to provide billable clinical services added to an already challenging work environment.
To address current Health Human Resources (HHR) challenges, strategies are expected to focus on five distinct areas. What are they?
- Recruitment
- Retention
- Mental Health and Well-being
- Data for Planning and Management
- Productivity and Models of Care
What to know about ‘recruitment’ to address the area of HHR challenges? (3)
- Increasing demand for health care, especially ambulatory and community-based care.
- Canada is vulnerable due to an overreliance on internationally educated HCPs
- The WHO projects a shortage of more than 15 million health care workers globally by 2030. - Also need to recruit HCPs who reflect our increasingly diverse population.
- To support culturally safe and inclusive health care needed to optimize patient outcomes.
With recruitment, challenges unique to pharmacy include: (2)
- An insufficient number of domestic pharmacy graduates to meet employer demand.
- An especially high reliance on IPGs. - Scopes of practice vary a great deal between provinces, making it difficult for pharmacists to move to areas with greater demand.
- The mobility of pharmacy technicians is seen as even more restricted.
Pharmacy data on retention is quite limited but a 2023 CPhA* survey indicated: (3)
- 40% of pharmacy professionals found work fulfilling;
- 43% were considering reducing their hours; and
- 28% likely/somewhat likely to leave the profession in the coming year
Career pathways important for keeping health workers engaged over the long term. How does that apply to pharmacy?
While pharmacy has some formal structures, such as hospital residencies, these are limited and overall, there is a lack of well-defined career paths for pharmacists.
Post-pandemic saw a significant exodus of experienced health workers. Why? (4)
- Partly due to many workers staying past their retirement age to provide care during the pandemic.
- Leave once the ‘crisis is over’.
Other Contributing Factors: - The work itself - extremely draining and difficult;
- Salaries that failed to keep pace; and
- Deteriorating workplace conditions:
- Increased workloads and responsibilities with decreased supports during and after the pandemic.
Workforce well-being affects workforce retention, as well as the quality and safety of the care provided by the workforce. How did the pandemic affect that?
During the pandemic, rates of severe emotional, physical and mental exhaustion among health care workers more than doubled by mid-2021
Burnout is seen by many as the most urgent issue in health care. What is it linked to? (4)
- Underperformance
- Quality-related issues
- Heightened rates of error
- Ultimately causes health workers to quit their positions, and even their professions
What is workplace burnout?
A psychological response to work related stress that presents as increased emotional exhaustion and depersonalization, and reduced feelings of personal accomplishment.
What are 3 aspects of burnout?
- Emotional exhaustion
- Feeling that you have no power or control over what happens; feeling “stuck” or “trapped” in a situation. - Depersonalization
- Feeling disconnected from your work and viewing yourself and others as mere objects - Lack of personal accomplishment
- Feeling your work is not meaningful or that you are not making a difference; feelings of inadequacy or self-doubt exacerbate burnout.
Risk of burnout is exacerbated by what?
Equity and inclusivity issues due to large proportion of female workers, and growing number of racialized workers in health care.
- Workplace abuse, bullying, violence and threats of violence
What to know about Planning and Management Data in pharmacies in Canada? (2) - Aka why is it bad right now?
- Canada behind other countries in terms of national workforce data for HHR planning and management.
- Demographics, specializations, workloads, etc. - Pharmacy in particular lacks this type of readily accessible information.
- Uncoordinated patchwork of data sets
- Large corporate employers generally do not share this data for competitive reasons;
- Independent pharmacies rarely collect this data; and
- Hospital-based data segregated from other pharmacists
Compared to other professions, pharmacy has some unique advantages. Such as? (3)
- Cooperation among different arms of profession;
- Pan-Canadian organizations that seek consensus;
- A track record of cooperation and adaptability in both unionized and nonunionized settings.
What to know about Productivity and Models of Care in pharmacy? (2)
- Significant mismatch between tasks and qualifications throughout health care.
- Pharmacists not only ones not working at the “top of their license”. Nearly 80% of nurses and 76% of physicians overqualified for many of the tasks they perform. - Pressure to expand pharmacists’ scope of practice to address issues in primary care; but some question if it can be done in a coordinated and consistent manner?
- Concerns about impact on an already overworked, overstressed and fragile pharmacy workforce
