iImplementation science is an emerging concept examining the development of services in a way that not only helps ensure their initial execution but also their sustainability over time.
Community pharmacy continues to evolve into a hub for the delivery of public health services, including immunizations, contraceptive dispensing, and the provision of drugs for traveling, as well as the administration of point-of-care testing. Offering new services is key to ensuring that community pharmacies are viewed as a valuable resource for the entire public. This is especially true when considering emerging forces that are shaping health care delivery, including but not limited to Amazon and other web-based delivery services previously outside of pharmacy, in addition to shifting patient help-seeking patterns and preferences post-pandemic. To that end, the successful execution and implementation of value-added services is more important than ever.
Sui et al. examined factors that contributed to the successful implementation of diabetes screenings in community pharmacy. The authors defined high versus low performance (uptake) based upon the number of screenings performed during a period of 3 months and conducted interviews of 12 high- and 9 low-performing pharmacies.1 Major themes identified were pharmacy staff engagement, operationalization, and external engagement.1
These findings align with the idea of implementation science, an emerging concept examining the development of services in a way that not only helps ensure their initial execution but also their sustainability over time. The results also corroborate previous evidence that successful implementation of pharmacy services requires a champion to eagerly yet carefully oversee their implementation, prioritize the services implementation as a core goal and value, ensure proper staffing for delivering the service, and ensure ease of execution. Championing the services’ perceived value among your patients and clients is also important.2 Operationalization includes planning the service by creating a protocol and developing an operations manual to define the assignment of responsibilities, recruitment targets, and documentation software.1 External engagement takes into account patient demographics and case mix, along with managing service expectations to enhance perceived value by patients.
Pharmacy managers can use strategies inherent to implementation science to ensure success even without having to delve that deeply into the discipline of implementation science. However, familiarity with some of its main tenets would be helpful. In the study by Sui et al, recruiting eligible screening candidates was one of the main barriers for both high and low performing pharmacies.1 Identifying the target population of a service is crucial. For example, offering point-of-care testing services may be very relevant in rural locations or other areas where other health providers are relatively scarce.
Additionally, pharmacy managers must be able to identify the pharmacy’s strengths and weaknesses. They must account for the current availability and willingness to invest in staff training, workflow redesign, services marketing, and operations planning. Also, although planning is important, performance in real-time is likewise critical. This requires attention to both the prevailing model of business (medication dispensing) and to the new services delivery so that staff engagement and revenues from both are concurrently maximized. This will ensure that community pharmacy continues to survive and thrive.
More information about Implementing Value-Added Pharmacy Services can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.
Valerie Wasem is a PharmD Candidate at Touro University in California.
Shane P. Desselle, PhD, is a professor of social and behavioral pharmacy at Touro University in California.