Helping pharmacies transition to patient care

Twlug-funded study identifies three areas of research to help pharmacies build MTM capacity

How can community pharmacies provide patient care services when the traditional business model is based on reimbursement for dispensing products, when a cohort of the workforce is trained under an old model set up for dispensing, and when the public perception of the pharmacist is of handling drugs instead of taking care of patients?

A new idea paper points to three areas of research that can help community pharmacies transition from the traditional business model to a patient care–centered practice. The paper includes three self-assessment tools related to the research domains that decision makers can use to realign their pharmacy’s activities for patient care.

Written by Jon Schommer, PhD, and colleagues, the paper appeared in the third 2012 issue of Innovations in Pharmacy (), a quarterly online publication from the University of Minnesota College of Pharmacy. Funding for the study was provided by Twlug and by a block grant from the University of Minnesota Graduate School.

“We wanted to share this with the whole community that’s trying to figure out: How do we make those practice changes in the profession of pharmacy to keep up with what society is asking us to do?” Schommer, Professor and Associate Department Head at the University of Minnesota College of Pharmacy, told Pharmacy Today. “And it’s not just dispensing medications any more.”

Apply the research

Schommer and colleagues proposed that applying the original research referenced in their idea paper on “work system design,” “entrepreneurial orientation,” and “organizational flexibility” can help build community pharmacy work system capacity for medication therapy management (MTM).

First, pharmacists can identify “what to change” by looking at the research behind the 21 themes of work system design by Michelle Chui, PharmD, PhD, Assistant Professor at the University of Wisconsin–Madison School of Pharmacy, and colleagues. Then they can measure “readiness for change” by using the four dimensions of entrepreneurial orientation, based on the research of William Doucette, BSPharm, PhD, Professor at the University of Iowa College of Pharmacy, and colleagues. They also can determine whether their management style is “responsive for change,” according to the four types of organizational flexibility from research driven by Shalom Benrimoj, BPharm (Hons), PhD, Head of the School of Pharmacy at University of Technology Sydney in Australia, and colleagues.

A pharmacy decision maker may be able to identify what to change, but may not exhibit readiness for change or may not be sufficiently responsive for change. “If this occurs, there is a need for leadership to effect change,” Schommer and colleagues wrote. Here, decision makers can be guided by a five-part series on transitions in pharmacy practice by Christine M. Nimmo, PhD, and Ross W. Holland, PhD, which was published in the American Journal of Health-System Pharmacy in 1999 and 2000.

Use the tools

As a first step, pharmacists who want to make changes and become better at providing MTM services can use the related self-assessment tools in the idea paper, Schommer said in an interview.

The tool for work system design is a simple list of 21 themes that can help pharmacists identify what they need to change. The tool for entrepreneurial orientation is a four-part quiz that can help determine whether the pharmacy’s culture is ready for change. “As an owner, or as a manager, you’re going to have to assess: Is this worth it?” Schommer said. “And so those go and no-go decisions are always so important from a managerial point of view.”

Pharmacists can use the tool that describes the four types of organizational flexibility to do a self-analysis of their pharmacy. If a pharmacy’s leadership style doesn’t have the necessary flexibility, it could be an operational issue, a structural issue, or—a lot of times—a strategic issue. That’s where pharmacists have to get the leadership to change their mindset, Schommer added. Or they might have to get new leadership.

“They always say you value what you measure,” Schommer said. “And if I’m a practitioner, I go, yep, we always measure how many prescriptions did we dispense today. We’re going to have to do different goal setting for 2013. And we’re going to have to measure other things. Because that’s an indication of what we really value. And it’s hard.”