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...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Hamde Nazar (1733509) (author)
مؤلفون آخرون: Zachariah Nazar (8600154) (author)
منشور في: 2021
الموضوعات:
الوسوم: إضافة وسم
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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
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identifier_str_mv 10.1016/j.sapharm.2020.07.017
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/24242497
publishDate 2021
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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