The Transformation of Pharmacy Concepts into Building and Organization

Abstract

To explore the transformation of soft systems pharmacy concepts, with a special attention for pharmaceutical care, into hard systems properties of building and organization in community-based pharmacy practice in The Netherlands. The applied methods for data-collection were interviews. The interviews were conducted at eight community pharmacies and four architectural firms. The central topics in the questionnaire were the building and the design process. The role of the architect was included in the questions for the pharmacist and the role of the pharmacist was included for the architect. The data were completed with simple observations, relevant documents, designs, photographic material and bills of quantities of best, ordinary and worst case practices. The data were used to address the coherence between pharmacy, building, and organization. The main outcome measure was the relevance for the objective of the study. Data-selection was based upon its supposed connection with the transformation of soft into hard systems. The main focus was on documentation, classification, and derivation that would improve the current understanding of the transformation of a pharmacy concept, especially pharmaceutical care, into building and organization. No further data-selection was made. The results show that architectural and organizational designs are actually used in the support of pharmaceutical care. A large variety of soft and hard systems were observed. However, pharmacists seem to agree on the use of the soft systems key words 'professional', 'accessible', and 'transparent', and also on the activities with respect to the provision of information and the cooperation with other disciplines. Although most observed transformations appear sensible, hard evidence provided by the pharmacist is very poor. The full impact of the implemented changes on pharmaceutical care or other concepts remains a mystery. There is a large variety of different hard properties in building and organization, reflecting different (but still related) soft pharmacy concepts. The connections in building and organization are regarded as the resources that make the provision of care possible. Observed were resources to support the provision of written and oral information, the conversation setting, and the cooperation with other professionals. Potentially important developments for pharmaceutical care are the separate consultation room, the multi-disciplinary health centre, and robotization. This study has revealed some of the interdisciplinary relations between pharmaceutical, architectural, and organizational designs in Dutch community pharmacy practices. From this study we can conclude that interventions in building and organization are actually used in the support of pharmacy concepts, specifically of pharmaceutical care. However, the hard evidence of supposed improvements remains poor and mostly absent.