Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis

Moullin, JC; Sabater-Hernández, D; Benrimoj, SI

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis

Moullin, JC Sabater-Hernández, D

Benrimoj, SI

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Publication Type:: Journal Article
Citation:: BMC Health Services Research, 2016, 16 (1)
Issue Date:: 2016-08-25

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Field	Value	Language
dc.contributor.author	Moullin, JC	en_US
dc.contributor.author	Sabater-Hernández, D https://orcid.org/0000-0001-7419-8740	en_US
dc.contributor.author	Benrimoj, SI https://orcid.org/0000-0001-9768-7838	en_US
dc.date.available	2016-08-18	en_US
dc.date.issued	2016-08-25	en_US
dc.identifier.citation	BMC Health Services Research, 2016, 16 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117030
dc.description.abstract	© 2016 The Author(s). Background: Multiple studies have explored the implementation process and influences, however it appears there is no study investigating these influences across the stages of implementation. Community pharmacy is attempting to implement professional services (pharmaceutical care and other health services). The use of implementation theory may assist the achievement of widespread provision, support and integration. The objective was to investigate professional service implementation in community pharmacy to contextualise and advance the concepts of a generic implementation framework previously published. Methods: Purposeful sampling was used to investigate implementation across a range of levels of implementation in community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a framework methodology. Data was charted using implementation stages as overarching themes and each stage was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation. Results: Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences (pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified. The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely. Evaluations were lacking. Conclusions: The process of implementation and five overarching influences of professional services implementation in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences, factors influencing implementation varied across the implementation stages. It is proposed at each stage, for each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.	en_US
dc.relation.ispartof	BMC Health Services Research	en_US
dc.relation.isbasedon	10.1186/s12913-016-1689-7	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Qualitative Research	en_US
dc.subject.mesh	Pharmacists	en_US
dc.subject.mesh	Pharmacies	en_US
dc.subject.mesh	Community Pharmacy Services	en_US
dc.subject.mesh	Health Plan Implementation	en_US
dc.subject.mesh	Health Services Research	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Interviews as Topic	en_US
dc.title	Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	16	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	0807 Library and Information Studies	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	16	en_US

Abstract:

© 2016 The Author(s). Background: Multiple studies have explored the implementation process and influences, however it appears there is no study investigating these influences across the stages of implementation. Community pharmacy is attempting to implement professional services (pharmaceutical care and other health services). The use of implementation theory may assist the achievement of widespread provision, support and integration. The objective was to investigate professional service implementation in community pharmacy to contextualise and advance the concepts of a generic implementation framework previously published. Methods: Purposeful sampling was used to investigate implementation across a range of levels of implementation in community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a framework methodology. Data was charted using implementation stages as overarching themes and each stage was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation. Results: Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences (pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified. The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely. Evaluations were lacking. Conclusions: The process of implementation and five overarching influences of professional services implementation in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences, factors influencing implementation varied across the implementation stages. It is proposed at each stage, for each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.

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http://hdl.handle.net/10453/117030