Pharmacy Leaders Research Articles

Pharmacy Leaders’ Reflections on Leadership and Legacy

ObjectiveTo explore the experiences, contributions, and perceived legacy of individuals recognized as leaders in the pharmacy profession and compare these by gender and generational category. MethodsA total of 54 leaders were interviewed about their journey to leadership and the legacy they leave to the profession. Interviews were transcribed, de-identified, and qualitatively analyzed using an inductive, modified constant comparison approach for open and axial coding. Qualitative responses were quantified to allow for the comparison of themes by gender and generational category. ResultsCommon leadership themes included: humility, not expecting to be in a leadership role, taking initiative, being passionate about their work, having mentors to guide them, having a network of people around them, being a part of change, serving during a challenging time, seizing opportunities when they presented themselves, and being involved in professional organizations. The individual’s clinical work (38.9%), helping to develop pharmacy as a clinical profession (33.3%), publications (29.6%), impact on students (29.6%), building programs (22.2%), involvement in organizations (20.4%), and impactful research (16.7%) were common themes noted in the legacy responses. ConclusionAlthough there are many advancements still to be made, upcoming leaders would benefit from the journey and perceived legacy of these leaders as they carry the torch to advance the practice of pharmacy.

The Role of a Pharmacy Administration and Leadership Rotation within Postgraduate Year Two Critical Care Residency Training.

The job of a critical care pharmacy specialist has evolved to include quality improvement and administrative tasks. As such, the American Society of Health-System Pharmacists (ASHP) highlights specific goals and objectives to ensure post-graduate year two (PGY2) critical care residents are sufficiently trained to perform these tasks. The PGY2 critical care pharmacy residency leadership at the University of Kentucky sought to develop a four-week learning experience entitled, "Critical Care Administration / Medication Use Quality & Outcomes," as a unique rotation to capture these requirements and activities. The focus of this commentary is to serve as a guide for other residency programs to develop such a rotation, highlight resulting resident contributions to the department, describe perceived benefits of this rotation for residents, and highlight how this rotation impacted graduated residents' early years as practitioners. This learning experience is pivotal to providing a more balanced view of the entire medication use process and the healthcare ecosystem during a specialty residency. PGY2 critical care residents can gain valuable experiences away from the bedside that better prepare them for future tasks in addition to patient care that will be expected of them as clinical pharmacists.

Pharmacist-Led Discharge Transitions of Care Interventions for Pediatric Patients: A Narrative Review.

Transitions of care (TOC) before, during, and after hospital discharge are an opportune setting to optimize medication management. The quality standards for pediatric care transitions, however, are lacking, leading to reduced health outcomes in children. This narrative review characterizes the pediatric populations that would benefit from focused, TOC interventions. Different types of medication-focused TOC interventions during hospital discharge are described, including medication reconciliation, education, access, and adherence tools. Various TOC intervention delivery models following hospital discharge are also reviewed. The goal of this narrative review is to help pediatric pharmacists and pharmacy leaders better understand TOC interventions and integrate them into the hospital discharge process for children and their caregivers.

Cold chain experts look to future during latest ASHP forum.

ASHP’s third Executive Forum on Cold Chain Management convened virtually March 28 to share strategies for anticipating and responding to drug product integrity and supply challenges in an evolving marketplace. The meeting was the third in a series of events that brought together cold chain experts and pharmacy leaders to share ideas on optimizing the handling, storage, and transportation of medications. Forum attendees represented health systems, specialty pharmacies, wholesalers, distributors, pharmaceutical manufacturers, federal pharmacy, and other stakeholders. The March 28 session was moderated by Jason Chou, system vice president of pharmacy operations for Ochsner Health in New Orleans, LA. The main discussion topics were: In an opening poll, 76% of forum participants indicated they felt somewhat prepared for future cold chain requirements, and 6% said they were very prepared. Amanda Frick, senior clinical manager of Vizient’s Center for Pharmacy Practice Excellence, opened the forum with an overview of anticipated storage requirements for drug products that are expected to enter the market in the near future. Frick said the developmental pipeline includes a growing share of vaccines and other products that will require cold storage and transit.

Evaluation of oncology infusion pharmacy practices: A nationwide survey.

Oncology care continues to evolve at a rapid pace including provision of infusion-based care. There is currently a lack of robust metrics around oncology infusion centers and pharmacy practice. The workgroup completed a nationwide survey to learn about oncology-based infusion pharmacy services offered. The objective was to highlight consistent, measureable oncology-based infusion pharmacy metrics that will provide a foundation to describe overall productivity including emphasis on high patient-safety standards. A nationwide survey was developed via a workgroup within the Vizient Pharmacy Cancer Care Group beginning in April 2019 and conducted electronically via the Vizient Pharmacy Network from September to November 2020. The survey was designed to capture a number of key metrics related to oncology-based infusion pharmacy services. Forty-one sites responded to the survey. Responses highlighted hours of operation (median = 11.5), number of infusion chairs (median = 45). Staffing metrics included 7.1 pharmacist full-time equivalent (FTE) and 7.6 technician FTE per week. 80.5% of sites had cleanrooms and 95.1% reported both hazardous and nonhazardous compounding hoods. 68.3% of sites reported using intravenous (IV) technology, 50.0% measured turnaround time, and 31.4% prepared treatment medications in advance. There was variability among oncology infusion pharmacy practices in regard to survey responses among sites. The survey results highlight the need for standardization of established productivity metrics across oncology infusion pharmacies in order to improve efficiency and contain costs in the changing oncology landscape. The survey provides insight into oncology infusion pharmacy practices nationwide and provides information for pharmacy leaders to help guide their practices.

503 Barriers and facilitators to the development of pharmacy workforce digital skills– a qualitative study

Abstract Introduction The NHS Long Term Plan envisions a health and social care system that is patient-centred, equitable and safe, with staff who feel supported and enabled to do their work. Digitalisation is seen as essential to successful delivery of this, and its use to support medicines related activity continues to grow. Pharmacy staff need the necessary knowledge and skills to feel confident, competent and capable to use digital systems for patient benefit (1). However, development of Pharmacy workforce digital skills, and innovation with technology, continues to be a challenge (2). Aim This project aimed to, • define the barriers and facilitators faced by pharmacy staff, across an Integrated Care Provider, when developing digital skills. • create recommendations to enable pharmacy staff to develop the digital skills required to work with, and fully realise the potential of, digital systems in healthcare. Methods Senior pharmacy leadership staff from primary care, community pharmacy, mental health and secondary care, and front-line pharmacy staff from mental health and secondary care, participated in online focus groups and semi-structured interviews. Front-line pharmacy staff from Community Pharmacy and Primary Care did not participate in the focus groups and interviews. Their input was gathered through completion of a questionnaire. Thematic analysis was used to analyse the data. Results Pharmacists, Pharmacy Technicians and Pharmacy Assistants/Support Workers were recruited to the study. Seven themes were identified from the combined data set. These were, 1) Digital Knowledge and Skill Development, 2) Supporting staff with change, 3) Enabling Innovation, 4) Risks of poor digital skill development, 5) Technology as a barrier, 6) Leadership, and 7) Across the health care system. The themes informed a set of recommendations. One of the stronger themes identified by nearly all participants related to ‘supporting staff with change’. Participants described the scale and pace, resistance to and fear of change, and having to learn new skills and processes as a consequence of digital system implementation. Some participants observed variation in practice and changes in professional identity as they adapted and adopted digital systems. Some participants described themselves, and members of staff they managed, as having a fixed ‘can’t do’ mindset when faced with technology. Some participants recognised the potential with digital yet felt constrained by their roles and the restrictions set by digital system configuration. Discussion/Conclusion The changes that occur in response to digital systems affect staff in multiple ways. Some effort is made in response to this through creation of a standard process for system use in clinical practice, but this is often months after digital system implementation. It is suggested that implementation is no longer considered and managed as a single moment in time, but is an iterative change process that incorporates alternative change models and tools to those currently used. This may improve staff adaptability, system use, digital skill development, innovation and realisation of health technology benefits. A weakness of the study is limited participantion from front-line Community and Primary Care pharmacy staff.

Assessing Student Perceptions of Blended and Online Learning Courses in Pharmacoeconomics, Management, and Leadership

Objective. Blended learning combines traditional face-to-face education with online instruction. This learner-centered approach has been shown to improve student engagement, critical thinking, and performance outcomes. The objective of this study was to assess and trend student pharmacist perceptions of blended and online learning used to teach pharmacy management, leadership, and economics within a Doctor of Pharmacy (PharmD) curriculum.Methods. Qualitative methods were employed using in-depth, semistructured interviews. Second- and third-year student pharmacists were recruited by purposeful and snowball sampling and interviewed to a point of saturation. The interview guide was based on social cognitive theory. Themes identified through initial deductive thematic analysis were categorized by the three domains of social cognitive theory: cognitive, behavioral, and environmental factors. The coding team additionally analyzed the transcripts using inductive thematic analysis to ensure no themes outside of social cognitive theory were missed.Results. Twenty students were interviewed. Themes reveal perceptions that blended learning facilitated greater understanding of course material, increased motivation among learners, provided more flexibility in workload completion, and was a more enjoyable way to learn compared to traditional didactic instruction. Furthermore, blended learning offered additional distinct advantages over traditional and online-only pedagogies.Conclusion. Student pharmacists perceived blended and online learning positively and acceptable for the delivery of a pharmacy course on management, leadership, and economics over traditional didactic instruction. Blended learning may enhance innovation, leadership, management, and economics content delivery and the student learning experience.

Pharmacy deans, health-system executives strategize on shared challenges.

A first-of-its-kind event at the 2022 Midyear Clinical Meeting & Exhibition brought together pharmacy school deans and pharmacy leaders from health systems to identify mutual challenges and discuss collaborative approaches to overcoming them. “That was the most energizing of all of the meetings I attended at the Midyear,” said Lindsey R. Kelley, associate chief of pharmacy at University of Michigan Health. During each Midyear meeting, ASHP invites the deans of the nation’s accredited schools and colleges of pharmacy to discuss societal and healthcare trends that affect pharmacy education and to identify common areas of focus. The 2022 meeting was the first time health-system executives were invited to the event. The agenda focused on collaboration between health systems and academia, pharmacy practice advancement and advocacy, and improving the workforce pipeline. Kelley said it was enlightening to discuss how the declining enrollment of student pharmacists at the nation’s schools and colleges of pharmacy affects both health systems and academia.

Editorial

Abstract: 25th Annual National Convention of Association of Pharmaceutical Teachers of India (APTI) was organized by JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru from 2nd September to 4th September 2022 at JSS Medical Institutions Campus, Mysuru. The theme of the conference was “Empowering Academia for Advancing Pharmacy Education”. About two thousand pharmacy professionals, students, industrialists, scientists, and leaders from different states of the country took part in this three-day event. Among the participants, we received more than 60 full text manuscript from multiple streams to be considered for publication in APTICON 2022: Special Issue of Indian Journal of Pharmaceutical Education and Research (IJPER), which is an official journal of Association of Pharmaceutical Teachers of India (APTI). Read more...

Scoping of pharmacists’ health leadership training needs for effective antimicrobial stewardship in Africa

BackgroundAntimicrobial resistance (AMR) is a global public health concern currently mitigated by antimicrobial stewardship (AMS). Pharmacists are strategically placed to lead AMS actions that contribute to responsible use of antimicrobials; however, this is undermined by an acknowledged health leadership skills deficit. Learning from the UK’s Chief Pharmaceutical Officer's Global Health (ChPOGH) Fellowship programme, the Commonwealth Pharmacists Association (CPA) is focused to develop a health leadership training program for pharmacists in eight sub-Saharan African countries. This study thus explores need-based leadership training needs for pharmacists to provide effective AMS and inform the CPA’s development of a focused leadership training programme, the ‘Commonwealth Partnerships in AMS, Health Leadership Programme’ (CwPAMS/LP).MethodsA mixed methods approach was undertaken. Quantitative data were collected via a survey across 8 sub-Saharan African countries and descriptively analysed. Qualitative data were collected through 5 virtual focus group discussions, held between February and July 2021, involving stakeholder pharmacists from different sectors in the 8 countries and were analysed thematically. Data were triangulated to determine priority areas for the training programme.ResultsThe quantitative phase produced 484 survey responses. Focus groups had 40 participants from the 8 countries. Data analysis revealed a clear need for a health leadership programme, with 61% of respondents finding previous leadership training programmes highly beneficial or beneficial. A proportion of survey participants (37%) and the focus groups highlighted poor access to leadership training opportunities in their countries. Clinical pharmacy (34%) and health leadership (31%) were ranked as the two highest priority areas for further training of pharmacists. Within these priority areas, strategic thinking (65%), clinical knowledge (57%), coaching and mentoring (51%), and project management (58%) were selected as the most important.ConclusionsThe study highlights the training needs of pharmacists and priority focus areas for health leadership to advance AMS within the African context. Context-specific identification of priority areas supports a needs-based approach to programme development, maximising African pharmacists’ contribution to AMS for improved and sustainable patient outcomes. This study recommends incorporating conflict management, behaviour change techniques, and advocacy, amongst others, as areas of focus to train pharmacist leaders to contribute to AMS effectively.

Prolonged Intermittent Kidney Replacement Therapy.

Kidney replacement therapy (KRT) is a vital, supportive treatment for patients with critical illness and severe AKI. The optimal timing, dose, and modality of KRT have been studied extensively, but gaps in knowledge remain. With respect to modalities, continuous KRT and intermittent hemodialysis are well-established options, but prolonged intermittent KRT is becoming more prevalent worldwide, particularly in emerging countries. Compared with continuous KRT, prolonged intermittent KRT offers similar hemodynamic stability and overall cost savings, and its intermittent nature allows patients time off therapy for mobilization and procedures. When compared with intermittent hemodialysis, prolonged intermittent KRT offers more hemodynamic stability, particularly in patients who remain highly vulnerable to hypotension from aggressive ultrafiltration over a shorter duration of treatment. The prescription of prolonged intermittent KRT can be tailored to patients' progression in their recovery from critical illness, and the frequency, flow rates, and duration of treatment can be modified to avert hemodynamic instability during de-escalation of care. Dosing of prolonged intermittent KRT can be extrapolated from urea kinetics used to calculate clearance for continuous KRT and intermittent hemodialysis. Practice variations across institutions with respect to terminology, prescription, and dosing of prolonged intermittent KRT create significant challenges, especially in creating specific drug dosing recommendations during prolonged intermittent KRT. During the coronavirus disease 2019 pandemic, prolonged intermittent KRT was rapidly implemented to meet the KRT demands during patient surges in some of the medical centers overwhelmed by sheer volume of patients with AKI. Ideally, implementation of prolonged intermittent KRT at any institution should be conducted in a timely manner, with judicious planning and collaboration among nephrology, critical care, dialysis and intensive care nursing, and pharmacy leadership. Future analyses and clinical trials with respect to prescription and delivery of prolonged intermittent KRT and clinical outcomes will help to guide standardization of practice.

P02 Novel pharmacy roles strengthen the multidisciplinary hospital infection team

Abstract Background Pharmacists have an essential role to play in the NHS Long Term Plan. Hospital pharmacy departments need to develop novel roles to strengthen teams and improve patient care. In September 2017, Mid Yorkshire Hospitals NHS Trust appointed a consultant antimicrobial pharmacist along with an administrative apprentice to strengthen pharmacy and infection leadership and support the delivery of the antimicrobial resistance national targets. From January 2018 to June 2020, the infection team worked with locums but no substantive consultant microbiologists. Objectives To describe the benefits of developing novel pharmacy roles to strengthen an infection multidisciplinary team Methods A shortage of consultant microbiologists provided opportunities to develop and enhance other infection roles. These included one year of funding from Pathology for a Band 6 Specialist Pharmacy Technician. The role was subsequently funded by the Adult Community Services team to support the home intravenous antibiotic service. Senior support was provided by the Pathology Group Manager, Head of Infection Prevention and Control and Director of Pharmacy. The apprenticeship levy supported a Level 4 Data analyst qualification to develop the pharmacy administrator role. Two other infection roles were developed: Advanced Clinical Practitioner and Trainee Clinical Scientist, both of which could not be sustained for lack of adequate consultant microbiologist resources for clinical supervision within the team. Results The Specialist Pharmacy Technician coordinates the home intravenous antibiotic service. Clinical responsibility remains with the discharging consultant medical officer. The antimicrobial pharmacy team led the introduction of antibiotic elastomeric pumps for home use, saving 2500 inpatient bed days. Patient and staff feedback on the novel pharmacy roles has been positive. Band 5 Pharmacy Data Analyst – Antimicrobials responsibilities include clinical trial participation, data collection and analysis including ward level working, reporting and coordination of the audit programme. The role has enabled contribution to national research studies, including Antibiotic Review Kit (ARK-Hospital) and Procalcitonin: Evaluation of Antibiotic Use in COVID-19 Hospitalised Patients (PEACH). Through a new strategy, consultant microbiologist workforce has progressively grown back to three full time equivalents and a 4th post advertised, enabling an increase in participation in ward rounds, multidisciplinary team meetings, antimicrobial stewardship, infection prevention & control, Director of Infection Prevention and Control role and leading NIHR research trials. The consultant pharmacist remains in post as a senior leader, and also has a Trust role as Director of Innovation. This change provided funding for an increase from Band 3 to Band 5 data analyst, promotion of a senior Band 7 pharmacist to a Band 8a advanced clinical pharmacist, and conversion of a part time Band 7 pharmacist to a full-time role. Discussion An innovative approach to development of pharmacy, data, nurse and scientist roles has strengthened the infection service in a regional hospital and community services Trust. Pharmacy-led team meetings are now routine in the Trust allowing for more efficient use of consultant microbiologist time. Conclusions Potential future roles are further administrative support, pharmacy assistant, clinical nurse specialist – antimicrobials, and antimicrobial pharmacy team leader.

Virtual Social Networking Hours: A Vital Personal and Professional Avenue for Connecting Pharmacy Leadership Educators.

The American Association of Colleges of Pharmacy (AACP) Leadership Development Special Interest Group (LD SIG) created a Virtual Social Networking Hour (VSNH). The VSNH explored pharmacy leadership educators' connections through discussing topics of interest that influence current teaching and scholarship practices. The VSNH also served to connect members in the LD SIG through informal networking, which was vital during a time when in-person connection was heavily restricted due to the COVID-19 global pandemic. The VSNH functioned as both a space for members to connect with LD SIG leadership and other members of the LD SIG and a tool to areas of leadership development the SIG should explore in future programming. Each of the four sessions included a skeleton structure that grew organically based on the conversations of the attendees. Common themes of scholarship, adaptation to a virtual landscape, leadership, and student-focused endeavors were interwoven across all four sessions. The VSNHs have since become an integral component in LD SIG Programming.

Hormone replacement therapy pre-payment scheme is too 'complex', say pharmacy leaders

Women in England will be able to buy a new pre-payment certificate (PPC) for hormone replacement therapy (HRT) from 1 April 2023, the government has announced. The certificate, priced at £18.70 (the cost of two single prescription charges) will cover 43 HRT products and be valid for 12 months, but pharmacy leaders have warned that […]

The commission on pharmacy leadership's proposals threaten the very future it wants

The commission on pharmacy leadership's proposals threaten the very future it wants

Community pharmacies may have to provide COVID-19 vaccinations to stay in business, local pharmacy leaders warn

Community pharmacies may have to provide COVID-19 vaccinations to stay in business, local pharmacy leaders warn

Pharmacy leaders warn that funding for independent prescribing pilot programme could leave community pharmacies 'out of pocket'

Pharmacy leaders warn that funding for independent prescribing pilot programme could leave community pharmacies 'out of pocket'

Local NHS leaders invited to bid for additional funding to run pharmacist prescribing pilots

NHS England has broken ground on the much-anticipated community pharmacy independent prescribing pilots, inviting local integrated care leaders to submit expressions of interest for additional funding. Emails sent this week to pharmacy leaders, and seen by The Pharmaceutical Journal, reveal that integrated care system (ICS) leaders have been asked “to submit an expression of interest […]

Pharmacy bodies write to government over ‘lack of engagement’ with sector in long-term workforce plan

A total of 14 pharmacy leadership bodies have written to the government to express concern over what they describe as a “lack of engagement” with the sector over the NHS long-term workforce plan. Representatives of all the major pharmacy representative bodies — including the Royal Pharmaceutical Society (RPS), the Pharmaceutical Services Negotiating Committee (PSNC) and […]

The new Pharmacy Leadership Council must be established quickly

For far too long the plethora of disparate pharmacy bodies have worked predominantly independently, only to join together when mutually beneficial to do so — and usually with the interests of their members paramount — rather than those of the wider public and patients. This is unsustainable if the profession is to flourish and be […]