Home' Australian Pharmacist : Australian Pharmacist December 2014 Contents Australian Pharmacist December 2014 I © Pharmaceutical Society of Australia Ltd.
Support for implementation
The interview findings suggest the
importance of supporting community
pharmacies in the implementation
process of DMC. Interviewed
pharmacists expressed a belief that
the support they received through the
Implementation Program was crucial,
as the DMC service requires extensive
planning and organisation.
It was identified that the program
provided support in two forms. Firstly, it
provided tools and resources via training
and facilitation to overcome barriers in
the implementation process. Secondly, it
provided encouragement, incentive and
motivation to commence and continue
the delivery of DMC.
‘I am glad I joined (the program).
...it helped reduce the barriers to
implementing the service.’ Pharmacist 15.
‘ The program pushed us to do more
than we otherwise would have. Almost
incentivise in that it gave you goals
to go towards increasing the DMC.’
All participating pharmacists reported
they started delivering or had increased
delivery level of DMC during the first
month of the Implementation Program.
However the majority of participating
pharmacists were unsure if the DMC
has reached a sustainable stage in
their pharmacies. Most pharmacists
expressed that the DMC service would
continue as long as there was funding.
One pharmacist suggested ongoing
facilitation twice a year would be
‘I don’t feel that it (DMC) is just part
of everything else we do. It’s still
something that is in the back of our
mind, that we have to remind ourselves
about.’ Pharmacist 9.
Evaluation – TM facilitator’s
A focus group with eight TM
facilitators was conducted to gain their
perspectives of the Implementation
Program. The main themes that emerged
were the barriers to facilitation,
extended role as facilitators and the
outcome of this extended role.
Consistent with the findings from the
pharmacist interviews, the main barrier
faced by TM facilitators was the loss of
commitment from the owner or internal
champion towards the DMC service.
‘You can tell once they are not as
motivated, they start shifting the
blame, making excuses. Once staff loses
motivation, it is very hard to get it back,
very hard.’ Facilitator 5.
TM facilitators reported their main role
was to act as a guide throughout the
Implementation Program. They provided
support via problem solving and sharing
ideas, as well as constant motivation and
reminders to achieve goals.
‘....we shared ideas. For example
one pharmacy sent out a letter to
their customers which worked really
well, so sharing the idea between the
pharmacies.’ Facilitator 7.
‘In my role it was providing direction
and motivation. Knowing that I was
coming back into the store prompted
them (pharmacists and support staff )
to action.’ Facilitator 2.
There was consensus amongst
facilitators that they built and
strengthened business relationships
with participating pharmacies. They
also gained deeper insight to the
pharmacy workflow and had a better
understanding of professional pharmacy
services and the challenges pharmacies
were facing. This enhanced their
confidence to transfer the knowledge
they acquired to other pharmacies.
‘It enables me to build business
relationships with the pharmacies that
participated. That knowledge I have I
was able to share not only to the three
pharmacies that was involved [sic], but
other pharmacies as well.’ Facilitator 4.
The Implementation Program achieved
the initial implementation stage of
DMC in all participating pharmacies.
The two main components of this
program, training and facilitation, both
had an effect in instigating the DMC
service. Most participants found that
the facilitation was the main motivation,
however about half of the participants
believed the face-to-face training was
equally important. In the UK and New
Zealand, pharmacists were required to
undertake an accreditation course to
provide MUR services.
Training during the Adoption stage is
important to equip service providers
with the necessary knowledge about the
service as well as to build confidence.
During the initial Implementation stage,
ongoing facilitation that follows initial
training guides the service providers to
change their practice.
to plan and establish procedures to have
process as well as resources in place for
the new service.
In terms of the main barrier to
implementing DMC, commitment
has been shown to be the key to
achieving continuity of the service, as
other barriers can be overcome should
there be commitment to change. This
commitment can be driven by an internal
champion, who could be the pharmacy
owner, pharmacist employee or a support
staff, or an external facilitator, such as the
RDA Territory Managers. In this program,
all participating pharmacies nominated
their internal champion to work
closely with the facilitators. Although
the Implementation Program was not
planned to achieve sustainability due
to time restrictions, it was hypothesised
that once the external facilitation was
discontinued the responsibility of
maintaining focus and commitment
would be the internal champion’s
Participating pharmacies appeared to
have increased the number of DMC
delivered during the early stages of the
Implementation Program. There was also
increased use of RDA clinical resources
within the DMC service. However a
decline in the number of DMCs delivered
was observed across all states at Visit 5,
which was in December and January –
the busy end of year and holiday period.
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