Organizational procedures can maximize pharmacists’ role in primary care teams: A multiple case study

IntroductionPharmacists are often included on interprofessional primary care teams. Their inclusion has led to improved clinical outcomes, reduced harms, and reduced costs to the healthcare system. However, there are concerns they are underutilized and have unexplained variations in their roles. This study explored how the role of the pharmacist is negotiated in a primary care team setting. This presentation focuses on how organizational procedures can support role negotiation. Aims Objectives Theory or MethodsFive teams were recruited for a multiple case study completed using Yin’s approach. Using Goffman’s theories of self and impression management, negotiation of the pharmacist’s role was explored. Goffman’s theory outlines how individuals (e.g., actors) interact to achieve the object (e.g., role) of interactions. In this case study, how interprofessional team members negotiated to create the pharmacists’ role, including both tasks and their delivery was examined. Both interview data and documents were analysed using the Qualitative Analysis of Leuven to create themes. Data was analyzed both deductively and inductively to characterize negotiation and its enablers. Highlights or Results or Key FindingsThree cases were fully recruited. Participants described role negotiation as a smooth process without conflict. Often participants described pharmacists as willing to take on new tasks and deliver whatever was asked of them. In cases with strong organizational procedures, the pharmacists’ role was more proactive and less dependent on other team members (e.g., physicians). Organizations with strong procedures tended to negotiate more tasks for the pharmacist to perform independently and allow for direct access by patients. From document analysis, it was identified that organizations who documented their strategic goals and measured their progress towards these goals had more examples of maximizing the pharmacists’ role. They also discussed how the different roles on the team provided value to the team and contributed to their vision. Additionally, known organizational procedures provided a pathway for the pharmacist to ask for role changes, if needed. ConclusionsOrganizations that had more formal procedures discussed concerted efforts to maximize human resources within their organization and aligned them within their community. By organizations supporting or leading role negotiation, the pharmacist was able to better contribute to the organization, and independently and equitably deliver patient care. Implications for applicability/transferability sustainability and limitations Although the results are specific to the cases, they demonstrate an ability for “top-down” policies or programs to be effective for pharmacists’ role change. This may help to effectively and efficiently negotiate new tasks and share best practices across organizations as a mechanism for role change.