Recent Publications
The Safe Assured team and affiliated partners are frequently working on new projects and papers within the realm of promoting pharmacy safety. Some of the most recent publications, along with their main objectives and findings are shown below:
Barriers to the use of patient safety information sources by community pharmacies
Barker, J. R., Boyle, T. C., Tay, L., Bishop, A., Morrison, B., Murphy, A., MacKinnon, N. J., Murray, E., & Ho, C. (2019). Barriers to the use of patient safety information sources by community pharmacies. Research in Social and Administrative Pharmacy. https://doi.org/10.1016/j.sapharm.2019.02.015
This study explored barriers that may have limited the use of Canadian patient safety information sources by conducting semi-structured interviews with community pharmacy managers in the Halifax Regional Municipality of Nova Scotia, Canada. Main findings revealed that five barriers to incorporating safety information sources include (1) lack of time to access information sources and its contents, (2) too many sources of available information, (3) complexity navigating online information sources, (4) too much information not relevant to community pharmacy practice, and (5) lack of community pharmacy involvement in source design. These results indicate that safety of community pharmacy practices can be enhanced by increasing awareness of information sources, as well as consolidating and reducing information overload such that they better conform to pharmacists’ needs.
Pharmacists' Perceptions of Error Reporting Systems in Nova Scotia, Canada
Christopher Michael Hartt1, Ashley Jean MacDonald1, Heidi Weigand1, James Barker1, Neil J. MacKinnon2; 1Dalhousie University, 2Augusta University
Studies have shown that adverse effects (AE) for patient treatment in Canadian hospitals occur 7.5% of the time. However, government investment in information technology infrastructure that supports standardized identification, reporting, and tracking of patient safety data is lacking. The objective of the present study was to gather the voices of community pharmacists, registered pharmacy technicians, and pharmacy assistants from across Nova Scotia to learn about their respective experiences with Quality-Related Events and the reporting processes.
Five focus group meetings were conducted over a six-month period across Nova Scotia to facilitate engagement of different perspectives from community pharmacies around the province. Results show that the focus group participants had a commitment to minimizing and reporting but find the system both time-consuming and onerous. The most significant issue for management was the disconnect between the idea of the system and the punitive nature of the compliance culture. Findings suggest a need for a shift in the organizational culture in community pharmacies across Nova Scotia such that learning from mistakes is encouraged. This would in turn improve reporting practices and promote transparency of patient safety culture.
Understanding the Current State of Medication Incident Reporting Databases for Canadian Community Pharmacies and the Community Setting
Caitlin Muhl, BSc, MPH1; Julia Rodgers, BA, MA2; Sherry Elms, RPh, MScHQ1; James Barker, MA, PhD3; Christina Godfrey, RN, PhD1; Kim Sears, RN, PhD1; 1Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; 2Department of Political Science, Dalhousie University, Halifax, Nova Scotia, Canada, 3Rowe School of Business, Dalhousie University, Halifax, Nova Scotia, Canada
Medication incident reporting within Canadian community pharmacies has been historically overlooked. It is essential to understand the existing federal and provincial databases that capture medication incidents in these settings such that important reports and learnings can be shared across the country to promote best practices. This paper discusses which sources and programs for medical incident reporting are available, while highlights the significance of their role in promoting medication safety across Canada.
Understanding the Current State of Medication Incident Reporting Databases for Canadian Community Pharmacies and the Community Setting
Caitlin Muhl, BSc, MPH1; Julia Rodgers, BA, MA2; Sherry Elms, RPh, MScHQ1; James Barker, MA, PhD3; Christina Godfrey, RN, PhD1; Kim Sears, RN, PhD1; 1Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada; 2Department of Political Science, Dalhousie University, Halifax, Nova Scotia, Canada, 3Rowe School of Business, Dalhousie University, Halifax, Nova Scotia, Canada
Medication incident reporting within Canadian community pharmacies has been historically overlooked. It is essential to understand the existing federal and provincial databases that capture medication incidents in these settings such that important reports and learnings can be shared across the country to promote best practices. This paper discusses which sources and programs for medical incident reporting are available, while highlights the significance of their role in promoting medication safety across Canada.
Community Pharmacy Staff Perceptions of Error Reporting Systems and Processes
James Barker1, Christopher Michael Hartt1, Ashley Jean MacDonald1, Hamed Aghakhani1, Neil J. Mackinnon2; 1Dalhousie University, 2Augusta University
The present study sought the opinions of community pharmacy staff on their familiarity with and attitudes toward the Quality-Related Events (QRE) system. The survey, conducted using a five-point Likert scale, was designed to assess pharmacy staff perceptions of QRE reporting issues. Results indicate that QRE and Continuous Quality Improvement (CQI) practices have a generally positive impact on pharmacy staff attitudes about error reporting. However, respondents expressed a negative opinion regarding their ability to implement quality improvement actions from the QRE reports. There appears to be difficult in incorporating the information communicated back to them from their QRE reporting into workable and implementable safety practices. Further assessments of QRE reporting systems need to focus on enhancing user interface and on assessing markers of the system’s utility for enhancing safety in community pharmacies.
Pharmacists' Perceptions of Error Reporting Systems in Nova Scotia, Canada
Christopher Michael Hartt1, Ashley Jean MacDonald1, Heidi Weigand1, James Barker1, Neil J. MacKinnon2; 1Dalhousie University, 2Augusta University
Studies have shown that adverse effects (AE) for patient treatment in Canadian hospitals occur 7.5% of the time. However, government investment in information technology infrastructure that supports standardized identification, reporting, and tracking of patient safety data is lacking. The objective of the present study was to gather the voices of community pharmacists, registered pharmacy technicians, and pharmacy assistants from across Nova Scotia to learn about their respective experiences with Quality-Related Events and the reporting processes.
Five focus group meetings were conducted over a six-month period across Nova Scotia to facilitate engagement of different perspectives from community pharmacies around the province. Results show that the focus group participants had a commitment to minimizing and reporting but find the system both time-consuming and onerous. The most significant issue for management was the disconnect between the idea of the system and the punitive nature of the compliance culture. Findings suggest a need for a shift in the organizational culture in community pharmacies across Nova Scotia such that learning from mistakes is encouraged. This would in turn improve reporting practices and promote transparency of patient safety culture.
Charting the "New Normal" in Canadian Community Pharmacy Practice - Scoping Review
Sears K1, Rodgers J2, Muhl C3, Elms S3, Barker JR4, Durando P5, Belbin S6, Godfrey CM1; 1Queen’s Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, Queen’s University, Kingston, Canada, 2Department of Political Science, Dalhousie University, Halifax, Canada, 3Queen’s University School of Nursing, Queen’s University, Kingston, Canada, 4Faculty of Management, Rowe School of Business, Dalhousie University, Halifax, Canada, 5Bracken Health Sciences Library, Queen’s University, Kingston, Canada, 6London School of Hygiene and Tropical Medicine, London School of Economics, London, UK
This scoping review aimed to identify the practice and regulation changes in Canadian community pharmacy practice in response to the COVID-19 pandemic, and to assess what is currently being practiced within these settings. Given the rapid changes introduced by the pandemic, researchers for this review aimed to investigate how communities were being kept safe during times of constantly developing policies at all levels of government.
Results of the review indicated that in Ontario, pharmacists rely on regulatory bodies and professional association websites and emails as their primary source of information. In the pan-Canadian context, Health Canada granted pharmacists new permissions for prescribing, including extending/renewing prescriptions for periods beyond the durations prescribed by law, while simultaneously recommending that pharmacists should limit patient medication supplies to a maximum of 30 days. Most studies made a note that pharmacists were either unaware of or did not understand the information sent out via email by regulatory bodies and national associations.
The findings from this study show the importance of assessing the current practices of community pharmacies to provide a foundational benchmark for addressing the variations found. Future research is needed to develop strategies for clearer communication within the community pharmacy setting.