Pharmacists' perceptions of their professional role: insights into hospital pharmacy culture.

BACKGROUND Numerous studies have demonstrated the positive impacts of pharmacists on patient outcomes. To capitalize on these positive impacts, hospital pharmacy organizations around the world are now calling on pharmacists to shift their focus from distribution of medications to patient outcomes. This new emphasis is consistent with the vision statement for the profession of pharmacy in Canada, as set out in the Blueprint for Pharmacy: "Optimal drug therapy outcomes for Canadians through patient-centred care". Given the ambitious nature of this statement and these goals, it is essential to understand what pharmacists currently think of their practice. OBJECTIVE To conduct a qualitative and semiquantitative analysis of hospital pharmacists' perceptions of their role in patient care. METHODS A researcher posing as a University of Alberta student who was studying how health professionals use language to describe what they do contacted the pharmacy departments of all hospitals in Alberta. The "top-of-mind" approach was used in asking hospital pharmacists 2 questions: (1) How many years have you been practising pharmacy? (2) In 3 or 4 words (or phrases), from your perspective could you please tell me, "What does a pharmacist do"? These techniques were used to minimize the impact of social desirability bias. Content analysis was used to categorize hospital pharmacists' responses into 4 broad categories: patient-centred, drug-focused, drug distribution, and ambiguous. RESULTS A total of 103 phone calls were made to hospital pharmacies, and 85 pharmacists contacted in this way were willing to participate in the survey. Hospital pharmacists provided 333 individual responses to the question about their activities. Of these, 79 (23.7%) were patient-centred, 98 (29.4%) were drug-focused, and 82 (24.6%) were in the drug-distribution category. Ambiguous responses accounted for the remaining 74 (22.2%). CONCLUSION Aspects of care categorized as other than patient-centred should not be construed as unimportant. However, the fact that they were reported in this survey more frequently than patient-centred aspects suggests that hospital pharmacists in Alberta may have not fully embraced the concept of patient-centred care as outlined in the Blueprint for Pharmacy.

[1]  C. Holland An ethnographic study of nursing culture as an exploration for determining the existence of a system of ritual. , 1993, Journal of advanced nursing.

[2]  G. Bloor,et al.  Understanding Professional Culture in Organizational Context , 1994 .

[3]  Michael J Dooley,et al.  A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. , 2004, British journal of clinical pharmacology.

[4]  J. Dasta,et al.  Scope of International Hospital Pharmacy Practice , 2005, The Annals of pharmacotherapy.

[5]  Howard R. Moskowitz,et al.  Sensory and Consumer Research in Food Product Design and Development , 2006 .

[6]  How True Is True? Assessing Socially Desirable Response Bias , 2003 .

[7]  J. Lawson STRANGERS TO OURSELVES: Discovering the adaptive unconscious (Book) , 2004 .

[8]  A. Amin,et al.  ASHP-SHM Joint Statement on Hospitalist-Pharmacist Collaboration. , 2008, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[9]  Janelle S. Taylor Confronting “Culture” in Medicine's “Culture of No Culture” , 2003, Academic medicine : journal of the Association of American Medical Colleges.

[10]  Theresa J. Schindel,et al.  Collaboration between pharmacists, physicians and nurse practitioners: A qualitative investigation of working relationships in the inpatient medical setting , 2009, Journal of interprofessional care.

[11]  I. Wong,et al.  Interventions of hospital pharmacists in improving drug therapy in children: a systematic literature review. , 2006, Drug safety.

[12]  F. Jansman,et al.  Evaluation of pharmacist clinical interventions in a Dutch hospital setting , 2007, Pharmacy World & Science.

[13]  Maurice Zarb Adami,et al.  Time and motion study for pharmacists' activities in a geriatric hospital , 2009 .

[14]  Robert Fritz The path of least resistance for managers : designing organizations to succeed , 1999 .

[15]  I. A. Fein,et al.  Clinical practice guidelines: culture eats strategy for breakfast, lunch, and dinner. , 2008, Critical care medicine.

[16]  Zubin Austin,et al.  Pharmacists' self-perception of their professional role: insights into community pharmacy culture. , 2011, Journal of the American Pharmacists Association : JAPhA.

[17]  J. Kotter,et al.  Corporate Culture and Performance , 1992 .

[18]  David CM Kong,et al.  Identification by observation of clinical pharmacists’ activities in a hospital inpatient setting , 2007, Pharmacy practice.

[19]  L. Nissen,et al.  Clinical Pharmacy Services in the Home , 2008 .

[20]  C. Raehl,et al.  Clinical Pharmacy Services, Pharmacy Staffing, and Hospital Mortality Rates , 2007, Pharmacotherapy.