Abstract
BackgroundMany rural hospitals in Australia and New Zealand do not have an on-site pharmacist. Sessional employment of a local pharmacist offers a potential solution to address the clinical service needs of non-pharmacist rural hospitals. This study explored sessional service models involving pharmacists and factors (enablers and challenges) impacting on these models, with a view to informing future sessional employment.MethodsA series of semi-structured one-on-one interviews was conducted with rural pharmacists with experience, or intention to practise, in a sessional employment role in Australia and New Zealand. Participants were identified via relevant newsletters, discussion forums and referrals from contacts. Interviews were conducted during August 2012-January 2013 via telephone or Skype™, for approximately 40–55 minutes each, and recorded.ResultsSeventeen pharmacists were interviewed: eight with ongoing sessional roles, five with sessional experience, and four working towards sessional employment. Most participants provided sessional hospital services on a weekly basis, mainly focusing on inpatient medication review and consultation. Recognition of the value of pharmacists’ involvement and engagement with other healthcare providers facilitated establishment and continuity of sessional services. Funds pooled from various sources supplemented some pharmacists’ remuneration in the absence of designated government funding. Enhanced employment opportunities, district support and flexibility in services facilitated the continuous operation of the sessional service.ConclusionsThere is potential to address clinical pharmacy service needs in rural hospitals by cross-sector employment of pharmacists. The reported sessional model arrangements, factors impacting on sessional employment of pharmacists and learnings shared by the participants should assist development of similar models in other rural communities.
Highlights
Many rural hospitals in Australia and New Zealand do not have an on-site pharmacist
Seventeen pharmacists participated in the interviews, 12 practising in Australia and five practising in New Zealand
While similar financial models have been reported in other rural Australian studies [15,22,23,30], this study provides additional insights into funds pooling options for sessional services involving pharmacists, in an Australian practice setting
Summary
Many rural hospitals in Australia and New Zealand do not have an on-site pharmacist. Sessional employment of a local pharmacist offers a potential solution to address the clinical service needs of non-pharmacist rural hospitals. The value of pharmacists’ discharge liaison and specialist medication review services, aiming to reduce medication misadventures and related hospitalisations, has been recognised [3,4] Despite this evidence, there is sub-optimal provision of medication management activities, such as inpatient medication reviews, medication reconciliation and medication counselling, in rural Australian hospitals [6,7,8,9]. There is sub-optimal provision of medication management activities, such as inpatient medication reviews, medication reconciliation and medication counselling, in rural Australian hospitals [6,7,8,9] This is mainly a result of rural pharmacist shortages, as rural areas pose a challenge to recruit and retain health practitioners, and to sustain adequate health services locally [10]. The roles of registered nurses in these rural hospitals have been extended to provide medication supply and basic medication information services, there have been reports of clinical and logistical challenges faced by the nurses, and the need for additional medication management support has been identified [6,7,9,11,13]
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