Optimizing clinical activities in pharmacies while integrating new services

Community pharmacies in Quebec alone provided more than 7 million clinical services last year—an average of 3,700 procedures per pharmacy. Among these services were some new responsibilities, which while certainly expected, were sometimes complicated to integrate into an already busy daily routine.“Expectations on pharmacies are high, we must give ourselves the organizational and financial means to do things well,” said Marie-France Nicole, community pharmacist and director of professional services at Alliance Pharma. “The current organizational model has been in place for half a century and is no longer adapted to today's pharmacy. Distribution aspect is no longer the prime thing, the clinical aspect has become more important.” But a demanding change like this requires patience and planning. Know how to communicateOffering new clinical services to your patients cannot be done without the support and participation of your entire team. While novelty can be exhilarating, it can also be a source of worry and stress, especially in a context of tight flow and busy days. Above all, it's about taking the pulse of the team, submitting your objectives to them while allowing them to express themselves. “You have to bring communication in the right way, and distill it so that it doesn’t become destabilizing,” said Nicole. “It’s also about welcoming comments and concerns, finding solutions together and involving the team in change.”It's also essential to remember the psychological impact these changes can have, says associate professor of human resources management Chloé Fortin-Bergeron: “Before even talking about the objectives to be achieved, we must consider the emotional impact of the change, through open discussions in groups or individually. Clearly stating your expectations and encouraging mutual support within the team will also help reduce concerns.”Establish an action planTo properly express your expectations, you need a firm grasp of what they are. Bringing a new clinical activity into pharmacy does not simply mean adding an item to a list. “You have to evaluate knowledge, update the guidelines, train your teams, define the role of each person in the care, document the file," says Nicole. “You have to have a vision of what you want to put forward in your pharmacy, and then establish this very concrete and standardized action plan, with objectives, based on the model of a travel itinerary, with the steps and timeline.”But be careful, all this must be done gradually, step by step, she warns. Time needs to be allocated to these preparatory stages, and the whole team needs to be involved. “We can even involve them in writing the action plan! Their ideas from the field will help make it happen.” Build on your team’s strengthsTo ensure the sustainability of your action plan, everyone must be on the same page to provide the “right care at the right time for the right person.” For that, a pharmacist needs to carefully evaluate their team. “Until now, we were using a deficit approach, identifying weaknesses and asking team members to strengthen them,” says Fortin-Bergeron. “But improving sometimes requires a lot more energy if it goes against our nature. And a negative comment will have a lasting impact on their motivation and self-esteem.”Rather, she management should focus on strengths: seeking to motivate a team by highlighting the positive immediately and often. Ask team members to verbalize their strengths themselves, or practice feedback, “both from the manager and between colleagues, to highlight the strengths observed in each person and allow them to come to fruition.”Establishing a caring working atmosphere, mutual support and recognition is a process that takes time, but with concrete and lasting effects, says Fortin-Bergeron.Learn to delegateOne of the best ways to show confidence in and highlight the strengths of your team members is to delegate more tasks to them. But delegation is a word that can spook pharmacists, who often worry tasks done by anyone but themselves will be done less well, less quickly or both. But it's absolutely essential, emphasizes Nicole. “I understand the reluctance of some pharmacists, because they are responsible for everything that is done in the laboratory. But I've observed that, properly carried out, delegation made it possible to strengthen the safety and effectiveness of clinical procedures.”However, this involves learning to tolerate mistakes. “For people to learn and improve, you have to give them the opportunity to fail, and to start again. But also value risk-taking, be open to doing things differently,” says Fortin-Bergeron. All must be done with a constructive approach, adds Marie-France Nicole: “It is necessary to establish ways to monitor errors, and give feedback to improve the process and quality controls at all times. When the staff is in demand, it empowers them and allows for better retention.” But there is delegating and then there is delegating well, says Fortin-Bergeron. “We must keep a notion of fairness in mind, because we will tend to always delegate to our star players, which can lead to dissatisfaction within the team. We must return to the management model by strengths, delegating according to the skills of each person, because we want to keep all our good players.”Reorganize your workspaceOnce the corporate culture has been reviewed, it’s time for concrete change the physicial workspace. Do you have enough space to receive patients? Do you have a private place to work in peace or to talk to a patient about a delicate subject? Can you concentrate on the same task for more than 30 minutes straight? If you answer 'no' to any of these questions, it may be time to review your pharmacy organization.“When you interrupt one task to perform another, it takes the brain on average 23 minutes to refocus on the initial task!” stresses Nicole. “And most of the time, these interruptions are irrelevant. Having a physical place that limits them, whether these interruptions come from colleagues or patients, helps reduce stress and fatigue and increases productivity.”Beyond this reconfiguration of physical space, more space must be given to task planning, says Nicole. “We've been trained to meet patients' needs in the order they arrive, but 75%-to-80% of pharmacy work can actually be scheduled, such as prescription refills for chronic conditions. For example. Many pharmacy software programs have functionality to manage pre-authorized or automated refills. This will also make it possible to be more efficient in handling unforeseen events.”Don't forget to invoiceFinally, don't forget a crucial points of clinical procedures in pharmacy: invoicing. Before thinking about charging for new services, focus on those you already provide, advises Nicole. “Many pharmacists don’t bill them, because they don’t think about it, because they don’t know that they can bill for this or that service or how to do it.”The perfect example is that of care, she says. “The majority of acts billed in 2023 were extensions and adjustments, and support accounted for less than 5% of billings. But, it's a great opportunity."Certain billings, such as those for renewals or dose adjustments, have become standard practice, but not necessarily those for the actions that accompany them, for example care for chronic pain, says Nicole. This article was translated from its original French and first appeared on our sister side Profession Santé.

Optimizing clinical activities in pharmacies while integrating new services

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