This project is being thrown out to the collaborative because of its massive scope and size. It is hoped the minds and input of many will develop a proposal that can be taken to the Saskatchewan Department of Health.
I invite pharmacy students from the Saskatchewan College of Pharmacy and Nutrition to participate in the collaborative. For that matter, I invite anyone with an interest in the project to participate. I am hoping the results of this collaborative will set the tone for pharmacy practice in Saskatchewan for years to come.
It is impossible to reward individuals for their participation and contribution, however I am willing to donate some funds to the College of Pharmacy and Nutrition to support a student function. I welcome suggestions and will work with the Dean to come up with a suitable focus for this support.
I am attempting to use the internet as a tool to enable the collaborative. My web developer, Mooseworld Inc., and I have not attempted anything like this before so it will be a learning experience. This document will be placed on my web site www.stueckpharmacy.com/collaborative as a blog.
The following serves as a brief outline of the problem and some points for consideration in developing the proposal. Do not consider the points as limiting. We want to develop this as completely as possible. Should you have a query or seek further explanation please contact me at gstueck@sasktel.net.
Background
Cypress Regional Health Authority (CRHA) recently undertook to have each pharmacy providing care to a care or nursing home within its boundaries sign a contract to establish a standard level of care across the district. Some pharmacies were providing exceptional service while others were providing, at best, marginal service. When I (Stueck Pharmacy) was approached about signing the contract, I wrote in a clause whereby my provision of a pharmacist on the care home premises for more than two hours weekly would be reimbursed at the pharmacist’s wage plus one third. Background here should include that Stueck Pharmacy has provided a Primary Care Pharmacist (when able to hire one) to the care home and/or local medical clinic as 0.5 FTE - at no charge to CRHA. I thought it about time Stueck Pharmacy be reimbursed for some of that time since we have proven our usefulness time and time again. Needless to say, CRHA refused to include the clause in the agreement, on the basis CRHA does not have the funds, and that, in any case, CRHA does not want to set a precedent throughout the district.
At this point, I refused to sign the care home agreement. After some discussion the following points were agreed upon between the CRHA representative and myself:
- pharmacy cognitive services should be reimbursed.
- the Regional Health Authorities (RHA’s) do not have sufficient funds in their current budgets to consider such a proposal.
- It is recognised in order to attract new pharmacy grads to rural areas one must use not only monetary incentives, but career opportunities. The CRHA can help me hire a primary care pharmacist by providing meaningful opportunity within CRHA to practice clinical skills.
- That utilising a primary care pharmacist within the CRHA will assist the CRHA in meeting its goals of improved patient care.
- That it would make sense for Stueck Pharmacy and the CRHA to share a pharmacist - it would meet both of our goals while providing a meaningful clinical position in a rural setting. The sharing of costs of hiring (which have soared in recent years) would be attractive to both Stueck Pharmacy and CRHA.
- that a proposal should be developed that the CRHA and pharmacy can take jointly to the Department of Health for extraneous funding outside the RHA funding.
Proposal
We need to develop a proposal to meet the above. The stated criteria need not be limited to that presented here. Some points to consider:
- benefits of clinical pharmacist involvement from a literature search.
- current working projects of similar nature (see New or North Bradford - England)
- role clinician can play in RHA and how patient care targets are jointly the same - how RHA is able to leverage a knowledge source economically. Currently RHA’s have an untapped resource they are not using since they view community pharmacies as ‘commercial entities’ only.
- should the RHA contract directly with the individual pharmacy (my choice) or the individual pharmacist. With the pharmacy keeps the local pharmacy ‘on the team’.
- how would each of the parties attain their goals under the aforementioned. (ie. the pharmacy would have an interested pharmacist on staff while the RHA is able to access unique abilities not previously available to their patients).
- how would one measure and capture data to support the program.
- discussion on the types of problems that could be encountered and their avoidance.
- dispute resolution process between pharmacy/RHA
- financial data for a one year experiment?
The above is to serve only as a guideline. Further queries may be direct to gstueck@sasktel.net
This is a massive project - more than one or two people could hope to accomplish in a reasonable amount of time. Throwing this out to interested students brings in partners of diverse talents with a common goal - to see pharmacists utilised fully in a satisfying and fulfilling career.