Hospital diversification: how to involve the pharmacy

Participation by hospital pharmacy departments in planning and development of diversified services is described. Diversification requires market planning. Seven basic marketing steps are identification of mission, goals, and objectives; identification of growth strategies (market penetration, market development, product development, and diversification); market analysis of external factors (size, growth, and logistics; reimbursement and financial considerations; competition; regulatory issues; and legal issues); market analysis of internal factors (departmental organization and reporting lines, demographics of the institution, and costs and productivity associated with the new service); program development and design; implementation; and evaluation. Hospitals can diversify by expanding acute-care services through management contracts and mergers; developing new services to include long-term-care, ambulatory-care, occupational-health, and wellness programs; starting other health-care ventures, such as consulting, continuing medical education, and continuing education for nurses; and expanding into non-health-care businesses. Vertical diversification is finding new markets for existing services; horizontal diversification is development of new services for new markets. To diversify, an institution may need to change its corporate structure; it may form a family of corporations that includes a university, nonprofit hospitals, holding companies, for-profit corporations, joint ventures, and service organizations. Through diversification, institutions and pharmacy departments can create alternative sources of funding and offer more comprehensive services to patients.     

Applications of mixed-methods methodology in clinical pharmacy research

Introduction Mixed-methods methodology, as the name suggests refers to mixing of elements of both qualitative and quantitative methodologies in a single study. In the past decade, mixed-methods methodology has gained popularity among healthcare researchers as it promises to bring together the strengths of both qualitative and quantitative approaches. Methodology A number of mixed-methods designs are available in the literature and the four most commonly used designs in healthcare research are: the convergent parallel design, the embedded design, the exploratory design, and the explanatory design. Each has its own unique advantages, challenges and procedures and selection of a particular design should be guided by the research question. Guidance on designing, conducting and reporting mixed-methods research is available in the literature, so it is advisable to adhere to this to ensure methodological rigour. When to use it is best suited when the research questions require: triangulating findings from different methodologies to explain a single phenomenon; clarifying the results of one method using another method; informing the design of one method based on the findings of another method, development of a scale/questionnaire and answering different research questions within a single study. Two case studies have been presented to illustrate possible applications of mixed-methods methodology. Limitations Possessing the necessary knowledge and skills to undertake qualitative and quantitative data collection, analysis, interpretation and integration remains the biggest challenge for researchers conducting mixed-methods studies. Sequential study designs are often time consuming, being in two (or more) phases whereas concurrent study designs may require more than one data collector to collect both qualitative and quantitative data at the same time.     

Q methodology: An underutilised tool in pharmacy practice research

Pharmacy practice research is often concerned with opinions, perspectives, values, or a variety of other subjective domains, whether that be in regard to the experiences of patients, views of stakeholders about innovative pharmacy services, or culture in pharmacy practice. This article offers a brief introduction to Q methodology, which is a philosophical, conceptual, and technical framework well-suited to shed light on such subjective views. Q methodology combines qualitative and quantitative processes to uncover distinct viewpoints present about any given topic. While other textual analyses focus on identifying the constituent themes about a topic, Q methodology instead detects and interprets holistic and shared perspectives. The introduction covers key theoretical principles, as well as the logistics and procedures involved in completing a Q-methodological study. Example data from a study investigating views on pharmacist integration into general practice in New Zealand are presented to highlight the potential of Q methodology for pharmacy practice research.     

执业药师如何在二级医院开展临床药学工作

临床药学是现代临床医学和药学相结合的一门新兴的综合性学科,主要研究临床合理用药、药物与人体间相互作用的规律,保证患者用药安全、合理、有效,使医院药学的模式由传统供应管理型向综合技术服务型转化。执业药师通过提高自身素质,加强与临床科室的沟通及协作,深入临床,采取多种措施积极开展临床药学工作,能够有效促进医院临床药学的发展,提高临床科室的合理用药。     

Social pharmacy strengthening clinical pharmacy: why pharmaceutical policy research is needed in Pakistan?

Pakistan has a population of more than 160 million and is the sixth most populous country in the world. Drugs are the most common form of treatment modality; however, inappropriate use of medicines is a crucial issue in the country. In Pakistan, recently there is a surge of number of pharmacy schools, the pharmacy degree (B. Pharm) has been changed to Pharm D and there is a lot of rhetoric about “clinical pharmacy”. However, whether this change has brought any significant improvement in drug use situation; it is still a moot question for academics and policy makers. Authors feel that before embarking upon on clinical pharmacy at an institutional level, it is important that basic pharmacy system should be in place. Thus, a strong culture in social pharmacy or pharmaceutical policy research will not only be helpful to establish clinical pharmacy practice, but it would also be supportive enough to provide manpower to the country’s proposed drug regulatory authority.     

The dilemma of clinical pharmacy research.

Clinical pharmacy research is defined as investigation of patient oriented drug related services. The dilemma is that Canadian practitioners have failed to do sufficient research in the area of clinical pharmacy programs, and this is desperately needed. A simple two-factor model is proposed to help explain the problem. Factors facilitating research are termed personal and enabling. Personal factors are: knowledge and skills in research design and statistical analysis, as well as personal qualities which include a positive attitude toward research, desire for involvement, and drive to carry it out. Enabling factors are leadership and support (resources, encouragement from management, time, and finance). It is suggested that lack of research skills in practitioners, lack of leadership, and lack of management support are prime reasons for the dilemma. The author proposes that: 1. undergraduates and graduates receive more formal instruction in research methodology and statistical analysis; 2. skilled researchers assume a leadership role, and; 3. research be encouraged by giving it a higher priority, by allowing adequate time for research, and by providing financial and political support.     

Ensuring rigour and trustworthiness of qualitative research in clinical pharmacy

The use of qualitative research methodology is well established for data generation within healthcare research generally and clinical pharmacy research specifically. In the past, qualitative research methodology has been criticized for lacking rigour, transparency, justification of data collection and analysis methods being used, and hence the integrity of findings. Demonstrating rigour in qualitative studies is essential so that the research findings have the “integrity” to make an impact on practice, policy or both. Unlike other healthcare disciplines, the issue of “quality” of qualitative research has not been discussed much in the clinical pharmacy discipline. The aim of this paper is to highlight the importance of rigour in qualitative research, present different philosophical standpoints on the issue of quality in qualitative research and to discuss briefly strategies to ensure rigour in qualitative research. Finally, a mini review of recent research is presented to illustrate the strategies reported by clinical pharmacy researchers to ensure rigour in their qualitative research studies.     

An introduction to clinical research and drug development for pharmacy and pharmacology graduate students

Recently at the University of Houston College of Pharmacy, a new course was introduced to provide an overview of each phase of drug development research, from the initial chemistry assays and cell biologystudies to animal experiments and finally clinical trials for drug approval. The course, entitled "Clinical Research and Drug Development," is a three-credit elective introduced this past yearfor the entry-level Doctor of Pharmacy (PharmD) students and graduate students during the summer session at the college. Overall, the intent of this course is to develop students' interest in the topic of clinical research and drug development and provide a foundation of knowledge of basic research skills used in the drug development process. The approach for this course was to break the topics into three general modules: laboratory techniques, both analytical and cell biology/molecular, used in the drug development process; aspects of clinical research process; and writing grants and protocols. Throughout the course, students were strongly encouraged to consider pursuing independent research projects to help continue to develop their research skills in preparation for postgraduate training. As a result, on completion of the course, four students requested an opportunity to complete an independent research project. This course has introduced the various components of drug development and of conducting clinical research to students in the PharmD and graduate programs at the University of Houston College of Pharmacy.     

浅议农村零售药店如何实施GSP

当前,农村药品零售企业GSP认证工作正在紧张进行当中,这对于提高农村药品经营质量,巩固农村药品供应网络建设具有重要的意义.但是,农村药品零售企业由于从业人员专业素质不高、企业软硬件建设投入不足等因素制约,在实施GSP过程中面临很多困难.因此,尽快提高农村药品零售企业实施GSP的意识,是摆在各级药监部门面前的一项重要课题.那么,农村药品零售企业如何才能有效实施GSP呢？笔者认为可以从以下六个方面入手：