Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service
<h3>Background</h3><p dir="ltr">Intervention planners need to be sufficiently cognisant of the health system landscape to facilitate embedding, adoption and diffusion of new services. Pharmacist-led transfer of care initiatives from hospital to community have been develop...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | |
| منشور في: |
2021
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| _version_ | 1864513555065208832 |
|---|---|
| author | Hamde Nazar (1733509) |
| author2 | Zachariah Nazar (8600154) |
| author2_role | author |
| author_facet | Hamde Nazar (1733509) Zachariah Nazar (8600154) |
| author_role | author |
| dc.creator.none.fl_str_mv | Hamde Nazar (1733509) Zachariah Nazar (8600154) |
| dc.date.none.fl_str_mv | 2021-04-01T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.sapharm.2020.07.017 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Adopting_a_systems_thinking_approach_to_investigate_the_implementation_and_provision_of_a_pharmacist-led_post-discharge_domiciliary_medicines_review_service/24242497 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Health services and systems Adopting systems medicines pharmacist-led |
| dc.title.none.fl_str_mv | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">Intervention planners need to be sufficiently cognisant of the health system landscape to facilitate embedding, adoption and diffusion of new services. Pharmacist-led transfer of care initiatives from hospital to community have been developed to address a health system flaw: patient hospital readmissions. A hospital in England partnered with a chain of community pharmacies establishing a domiciliary pharmacist medicines use review service (DMRS) for discharged patients to reduce hospital readmissions.</p><h3>Objectives</h3><p dir="ltr">We adopt a systems thinking approach to understand the adoption and diffusion of the service by investigating the perceptions of hospital and community pharmacy staff. The experience of a role swap between these settings is investigated to probe further system factors influencing service provision.</p><h3>Methods</h3><p dir="ltr">Semi-structured interviews informed by a conceptual model for the diffusion, dissemination and implementation of innovations, were conducted with hospital and community pharmacy staff between Oct–Dec 2016. Interviews were audio-recorded with consent, transcribed verbatim and a combination of inductive and deductive thematic analysis was used.</p><h3>Results</h3><p dir="ltr">Four each of hospital and community pharmacy staff were interviewed and four hospital staff were interviewed after the role swap. Staff indicated barriers and facilitators thematically related to organisational and individual-level components of a conceptual model about service diffusion and implementation. The role swap appeared to address the lack of a feedback loop, which was limiting engagement of hospital staff. The role swap led to improved trust and shared goals between the healthcare sectors and increased appreciation and self-efficacy of the hospital staff role.</p><h3>Conclusions</h3><p dir="ltr">A systems thinking lens offered the opportunity to investigate the wider healthcare system within which the DMRS was being provided. The role swap aligned to the principles of participatory design of an intervention to facilitate successful adoption and diffusion and contribute to more insightful evaluation about the process and context of service implementation.</p><h2>Other Information</h2><p dir="ltr">Published in: Research in Social and Administrative Pharmacy<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.sapharm.2020.07.017" target="_blank">https://dx.doi.org/10.1016/j.sapharm.2020.07.017</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_d0265b593a6680a45bf2fa7c5715c881 |
| identifier_str_mv | 10.1016/j.sapharm.2020.07.017 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/24242497 |
| publishDate | 2021 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review serviceHamde Nazar (1733509)Zachariah Nazar (8600154)Biomedical and clinical sciencesPharmacology and pharmaceutical sciencesHealth sciencesHealth services and systemsAdoptingsystemsmedicinespharmacist-led<h3>Background</h3><p dir="ltr">Intervention planners need to be sufficiently cognisant of the health system landscape to facilitate embedding, adoption and diffusion of new services. Pharmacist-led transfer of care initiatives from hospital to community have been developed to address a health system flaw: patient hospital readmissions. A hospital in England partnered with a chain of community pharmacies establishing a domiciliary pharmacist medicines use review service (DMRS) for discharged patients to reduce hospital readmissions.</p><h3>Objectives</h3><p dir="ltr">We adopt a systems thinking approach to understand the adoption and diffusion of the service by investigating the perceptions of hospital and community pharmacy staff. The experience of a role swap between these settings is investigated to probe further system factors influencing service provision.</p><h3>Methods</h3><p dir="ltr">Semi-structured interviews informed by a conceptual model for the diffusion, dissemination and implementation of innovations, were conducted with hospital and community pharmacy staff between Oct–Dec 2016. Interviews were audio-recorded with consent, transcribed verbatim and a combination of inductive and deductive thematic analysis was used.</p><h3>Results</h3><p dir="ltr">Four each of hospital and community pharmacy staff were interviewed and four hospital staff were interviewed after the role swap. Staff indicated barriers and facilitators thematically related to organisational and individual-level components of a conceptual model about service diffusion and implementation. The role swap appeared to address the lack of a feedback loop, which was limiting engagement of hospital staff. The role swap led to improved trust and shared goals between the healthcare sectors and increased appreciation and self-efficacy of the hospital staff role.</p><h3>Conclusions</h3><p dir="ltr">A systems thinking lens offered the opportunity to investigate the wider healthcare system within which the DMRS was being provided. The role swap aligned to the principles of participatory design of an intervention to facilitate successful adoption and diffusion and contribute to more insightful evaluation about the process and context of service implementation.</p><h2>Other Information</h2><p dir="ltr">Published in: Research in Social and Administrative Pharmacy<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.sapharm.2020.07.017" target="_blank">https://dx.doi.org/10.1016/j.sapharm.2020.07.017</a></p>2021-04-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.sapharm.2020.07.017https://figshare.com/articles/journal_contribution/Adopting_a_systems_thinking_approach_to_investigate_the_implementation_and_provision_of_a_pharmacist-led_post-discharge_domiciliary_medicines_review_service/24242497CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/242424972021-04-01T00:00:00Z |
| spellingShingle | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service Hamde Nazar (1733509) Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Health services and systems Adopting systems medicines pharmacist-led |
| status_str | publishedVersion |
| title | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| title_full | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| title_fullStr | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| title_full_unstemmed | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| title_short | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| title_sort | Adopting a systems thinking approach to investigate the implementation and provision of a pharmacist-led post-discharge domiciliary medicines review service |
| topic | Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Health services and systems Adopting systems medicines pharmacist-led |