THRIVING: How one pharmacist transformed her business to more services and greater profits

From the time Pam Kennedy opened her 1,600-square foot pharmacy in Bridgewater, N.S.—about an hour’s drive southwest of Halifax—the goal had been to focus on clinical services. She’s certainly in the right place for this. Her business, Bridgewater Guardian Pharmacy, is in a province that, like New Brunswick and Saskatchewan, is second only to Alberta when it comes to pharmacists’ scope of practice. That gave her the regulatory freedom to pursue her professional and business goal. But while Kennedy was already offering a certain level of services, she knew she could do more. She just needed to figure out how. “I was looking for guidance and that push to move to the next level of non-dispensing services,” Kennedy recalled. “But I wasn’t sure how to dive in and get started with it.” That all changed when she got accepted into Prescription to Thrive, a study launched in 2018 to develop a model for practice-centred change in the community pharmacy. Led by the Pharmacy Association of Nova Scotia and funded jointly by the province and a number of industry partners, Prescription to Thrive is based on 53 recommended changes to the pharmacy model with the goal of increasing efficiency to make room for non-dispensing services. Read: Nova Scotia pharmacists take over all COVID-19 vaccinations in the province “It’s also about changing culture and reducing stress,” said Allison Bodnar, executive director of the Pharmacy Association of Nova Scotia. “The recommendations range from something as simple as where the telephone is located in the pharmacy to IT acquisition and hiring of pharmacy technicians.” Working with 18 pharmacies in total, Prescription to Thrive completed its first two phases at the start of 2021. The results so far have been impressive. Participating pharmacies reported an aggregate growth in health management programs of more than 2,800% over 12 months, compared to the 12 months before the project began. Medication reviews increased by almost 775% while prescribing rose by close to 620%. These wins did not come easily, said Glenn Rodrigues, a facilitator who works directly with pharmacies in the program. A particularly big hurdle was convincing pharmacy owners to make strategic investments in their business. “It was a bit of a challenge to show owners that if they can invest in labour and technology, or even invest in building a second clinical room, they can improve patient care, job satisfaction, recruitment and retention,” said Rodrigues. “And they can make the pharmacy more profitable.” At Bridgewater Guardian, the goals that Kennedy defined through her Prescription to Thrive strategy included hiring a pharmacy technician and another pharmacist to allow Kennedy to focus more on services. To get there, Kennedy worked with Rodrigues to review her workflow and introduce process improvements. Read: Cross-country pharmacy check in with Alison Bodnar, PANS One of the first things they tackled was medication synchronization—a system for identifying patients with multiple medications up for renewal so that pharmacists can fill the prescriptions all at the same time. This saves pharmacists time and is more convenient for patients, who no longer have to come in numerous times to pick up their various meds. “For example if you get a 90-day supply we would set up an activity in our software that alerts us a certain number of days before your due date to call you, find out if there have been any changes with your condition and also ask if you need something else, like maybe more of your eye drops,” explained Kennedy. This proactive approach gives her team more control and allows them to serve patients better, she added. “Through med sync, we’re able to identify patients who are eligible for compliance packaging.” Rodrigues helped her integrate all prescribing templates and services forms into the pharmacy’s order management system. This shaved minutes off everyday tasks, which typically required Kennedy to switch between programs and apps. They also set up Bridgewater Guardian on the MedMe Health platform to enable online booking and virtual appointments for services such as assessments and renewals. “Before COVID I was doing phone assessments,” said Kennedy. “I just found that with virtual appointments you can get patients more engaged and you tend to have better conversations.” She hired a pharmacy technician within her first three months in the Prescription to Thrive program. “It didn’t take me long to realize that having her here was going to be integral to my practice,” said Kennedy. Read: Pharmacy Leader Zebrina Kassam: "We need to change the stereotypical narrative." Today, Bridgewater is a team of six, including two full-time pharmacists and a pharmacy technician. They’re ready for ramp-up, said Kennedy, with a full slate of clinical services that patients can access in an onsite walk-in clinic as well as online. Bridgewater recently became the only pharmacy in its community accredited for province’s Bloom Program, a pharmacy-based program that helps patients access mental and addiction resources and manage medication-related issues, at no cost to patients and with no waitlist. “Through the Bloom Program we can follow patients for up to six months with any type of mental health or drug-related problem,” said Kennedy. “We can even help people with problems handling their finances find a trustee in the community.” While Kennedy embarked on this journey so Bridgewater could grow its clinical service practice, the efficiencies she achieved through Prescription to Thrive will now allow her to increase prescription dispensing. “It’s all been really exciting,” she said. “You always think you need to be fully prepared to get started, but what I learned through this experience is if you commit to a goal and just work towards that goal you’re going to get there, with maybe a few tweaks along the way.” Read: If you've got it, flaunt it: Rite Aid’s Store of the Future puts pharmacists front and center

THRIVING: How one pharmacist transformed her business to more services and greater profits

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