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Millcroft Hospital Pharmacy Leadership Conference - June 1 - 3, 2007

Theme:Scope of Pharmacy Practice - What Will the Future Look Like?

What Could the Future Look Like?

Neil Johnson
Executive Editor
Hospital Pharmacy in Canada Report
London, ON

Johnson set the tone for the next part of the discussion by identifying some of the broader issues in the evolving role of hospital pharmacy. He recommended group members consider “value propositions,” which he defined as “the unique added value an organization offers customers through their operations; what differentiates you and your services from others.”

According to Johnson, pharmacy’s unique value propositions include: drug information; excellence in drug distribution and compounding; patient counselling; improved patient safety; identifying and resolving drug-related problems; and evaluating drug use. He asked participants for assistance in narrowing down this list. “We have no difficulty identifying many priorities, just prioritizing them,” he said.

The politics of health care:
  Health care doesn’t win elections, but it does lose them.
  Governments tend to implement structural changes before systemic changes.
  Is the physician payer model sustainable?
  Accountability should be considered.
  The impact of the Supreme Court decision regarding two-tiered health care should be considered.
  The impact of legislation and accreditation, and agencies such as the Joint Commission on Accreditation of Health Organizations (JCAHO) and the Canadian Council on Health Services Accreditation (CCHSA) should be considered.
Economic issues:
  The growth in health care funding is not sustainable, particularly if there is an economic turndown.
  Pressures from increased health human resources and drug-related costs should be taken into account.
Social changes:
  An aging population will have an impact.
  Expectations in younger consumers are changing, based on technology and electronic “connectivity.”
  There is a growing sense of health care entitlement.
  The gap between ”haves” and ”have-nots” is evolving.
Technological advances:
  Automated industrial technology has led to changes.
  Information technology advances have led to changes in point-of-care decision-making.
  The role of pharmacists is shifting with the advent of cutting-edge scientific advances, such as biotechnology and the human genome.

Johnson provided instructions for the next part of the conference process. Participants would break into small facilitated groups to think tactically about how to address some of the important identified issues. Before doing so, he asked them to consider several broad “realities”:

Johnson asked delegates to consider in their deliberations what he called the “hedgehog principle.” The hedgehog is a simple creature that does one thing extremely well: curling up into a defensive position, staving off threats with its quills, and not emerging until the danger has passed. While this model is disconcerting in some ways, it is an approach that characterizes many successful businesses. The challenge for hospital pharmacy might be to decide what core things it does well, and how to leverage those for future success.

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