Module 3, Implementation of professional services

Question 1

Examples of professional services…

Answer 1

• weight management
• child health
• smoking cessation
• womens health
• immunisation
• sleep apnoea
• wound management
• medication management
• medication adherance
• asthma management services
• diabetes services

Question 2

What makes an ‘innovative pharmacy’?

Answer 2

• higher financial turnover, remuneration focus
• ability to draw upon external assistance & support
• higher staffing numbers
• high value on professional aspects of servce
• diversification into new areas and niche markets
• focus on team work and communication (e.g. structured meetings)
• clear & achievable business indicators and shared goals to motivate, coah & reward staff
• strong desire to help people
• close ties with the community

Question 3

What makes an innovative pharmacy owner or manager?

Answer 3

• opportunistic; regularly change their business practices as opportunities arise
• forward thinking
• non traditional view
• ability to clearly articulate business vision
• superior marketing skills
• not bounded by the walls of the pharmacy
• check out other pharmacies
• leverage personal capabilities, technical expertise and experience

Question 4

What are the four stages on implementation?

Answer 4

1. Exploration stage
   1a. Research (problem analysis)
   1b. Theoretical framework
   1c. Vision
   1d. Business goals
   1e. People & money
   1f. Evaluation measures
2. Preparation stage
3. Testing stage
4. Operation stage

Question 5

Describe the exploration stage?

Answer 5

• conceptual design of the service- who, what, why, where, when, how
• early planning stages ensure the service
  
  • developed collaboratively
  • address an actual health problem or need
  • is grounded in theory and evidence
  • is tested and optimised in pharmacy setting
  • considers the circumstances that can reinforce, hinder or interact with the service

Question 6

Describe the research stage?

Answer 6

• gaps between current system & needs
• what needs to change and why; SWOT
  
  • S- strengths
  • W- weaknesses
  • O- opportunities
  • T- threats

Question 7

Describe the preparation stage?

Answer 7

• Identification of relevat clinical guidelines, protocols, regulations
• employ any additional/ allied staff e.g. dietician, diabetes educator
• staff traning, coaching & support
• marketing (product, place, promotion, people)
• patient consent & privacy procedues
• patient monitoring procedures
• infrastructure (facilities, equipment)
• patient educational materials
• referral processes

Question 8

Describe the testing stage?

Answer 8

• Uptake (if participating in a research trial) or trial/ pilot implementation of own service (required to produce evidence), to:
  
  • test & optimise (‘operationalise’) in the real world setting
  • assess implementation factors, strategies & evaluation procedures
• Program evaluation through periodic review/ audit, considering:
  
  • clinical outcomes
  • economic outcomes
  • humanisitc outcomes
  • process measures

Question 9

Describe the operation stage?

Answer 9

• sustained implementation
• maintenance of service setting
• aiming for perserverance of service outcomes
• ongoing evaluatio (review/ audit)

Question 10

What can get in the way of implementation of professional services in pharmacy?

Answer 10

• changing human behaviour
  
  • e.g. pharmacist habitually answering the phone
  • some people are naturally late adopters
• insufficient investment inn staffing, equipment, space, training
• insufficient staff engagement; need a change champion
• maintaining fidelity and consistency
• documentation requirements for research or reporting
• lack of commitment by patients
• attitudes of some GPs
• lack of formalised communication strategies

Question 11

What can help with barriers in implementing professional services in pharmacy?

Answer 11

• understanding the market being addressed
• skills (training, education)
• incentives
• human resources processes (required for growth, particularly amongst independent pharmacies)
• physical resources (infrastructure) e.g. reallocation of floor space for private and semi- private consultation areas
• for independent pharmacies, networking to increase buying power & so freeing up capitl for investment in staffing & service development
• documentation
• technology for patient management & marketing
• established relationships with health professionals and community groups relating to the professional service
• motivating factors & rewards that can provide the momentum to persist to full operation:
  
  • first patients recruited
  • first interventions
  • positive feedback
  • clinical outcomes
• collaborative, supportive environment
• coordination between complementary services provided by the pharmacy