eleventh seminar

Overview of Pharmacy Practice and Research

  • Speaker discusses their background and experiences within the pharmacy field and their transition to research.

  • Emphasizes the nature of problem-solving in pharmacy, particularly in community settings.

Background Information

  • Career Path

    • Started as a Pharmacy Technician in 2006 at age 18.

    • Earned a PharmD in 2013 and rose to become an assistant pharmacy manager.

    • Left a stressful corporate environment due to burnout.

  • Passion for Pharmacy

    • Initial interest stemmed from the practical role of pharmacists and the relative brevity of the education (4 years versus 12 in medicine).

    • Focused on supporting safe and appropriate medication use.

Role of Pharmacists

  • Primary Responsibilities

    • Ensures safe medication use in various settings:

    • Community pharmacies

    • Inpatient and outpatient care

    • Long-term care facilities

    • Mail order pharmacies

    • Conducts drug utilization reviews to manage drug interactions and ensure proper dosing based on patient conditions.

  • Patient Counseling

    • Engages and empowers patients in their healthcare decisions, emphasizing medication adherence over compliance.

    • Motivated by the goal of enhancing patients' understanding of their health and medications.

Educational Insights

  • Shift in Terminology

    • Transition from "medication compliance" to "medication adherence" reflects the importance of patient involvement in their own treatment.

  • Challenges Faced

    • Discusses barriers in patient communication and engagement, including emotional barriers and misconceptions about medications.

    • Emphasizes that information alone does not guarantee behavior change, necessitating psychological understanding.

Research Focus

  • Transition to Research

    • Pursued a PhD to explore real-world problem-solving without losing touch with clinical practice.

    • Focus on collaboration and how different demographics approach problem-solving in healthcare.

  • Dissertation and Research Topics

    • Examining the intersection of collaboration and problem-solving in healthcare.

    • Investigates how experts and novices differ in their problem-solving approaches.

Nature of Problems in Healthcare

  • Understanding Problems

    • Defines a problem as a gap between the current state and the desired state.

    • Emphasizes the necessity to recognize and care about resolving these gaps.

  • Types of Healthcare Problems

    • Differentiates between straightforward problems and ethical dilemmas.

    • Discusses the complexity of deciding on interventions in real-world scenarios, such as vaccination hesitance or resource allocation during pandemics.

  • Complexity Factors

    • Highlights cultural biases, lack of knowledge, and emotional responses as factors complicating healthcare decision-making.

    • Notes how the severity of a problem may vary based on the stakeholders' perspectives and experiences.

Real-World Scenario Analysis

  • Case Studies Presented

    • An elderly patient hesitant to receive the flu vaccine due to past experiences.

    • Struggles faced by healthcare professionals during the COVID-19 pandemic when hospital resources are limited.

    • Discussion of the ethical implications of prioritizing certain patients for limited antiviral medications during an outbreak.

Stakeholder Perspectives in Problem Solving

  • Importance of Identifying Stakeholders

    • Discusses how to identify stakeholders in healthcare dilemmas and their varying priorities.

    • Considers the goals of clinical teams, public health officials, pharmacists, and various community members when framing healthcare problems.

  • Communication and Negotiation

    • The necessity of communicating effectively among stakeholders to solve complex real-world healthcare problems.

    • Importance of understanding each stakeholder's knowledge base, assumptions, and views to construct a collaborative solution.

Key Takeaways for Future Problem Solving

  • Identifying the Problem

    • Ensure all stakeholders share a common understanding of the problem at hand.

  • Framing the Problem

    • Discuss the definitions, assumptions, and constraints surrounding the problem with involved parties.

  • Articulating Trade-offs

    • Recognize and discuss sacrifices that may need to be made in managing competing priorities.

  • Iterative Process

    • Problem-solving is a continuous process that may not yield simple solutions, often requiring multiple perspectives to reach an optimal approach.

Conclusion

  • Future Directions in Research

    • Speaker expresses desire to understand the challenges faced by people working in One Health contexts, emphasizing the interplay of values in problem-solving across disciplines.

  • Final Thoughts

    • Encourages students to reflect on the definitions of problems and their complexities in healthcare settings, emphasizing collaboration as key to effective problem-solving.

- participation in counseling

- medication compliance to medication adherence

! lack of knowledge, lack of want, emotional barriers, financial status, fear

- too scared or too negligent (!immunization)

- perspectices, experitise, scope of practice, one healthapproach, work examples

- problem? question or issue that is uncertain and so must be examined and solved,

produced when we discern a gap between the current and desired state aka goal.

- need to be capable AND concerned about the discernable gaps

- dilemma problem

- challenging more than others? lack of knowledge, ethical/morals, impact,

how do we frame and solve problems? Then how do you go about setting goals to

close the gap

SCENARIO #1: FLU SEASON, "LAST TIME I GOT THE FLU

stakeholders goals priorities and perspectics,

CLINICS: INDIVIDUAL SURVIVAL AND EARLY TREATMENT

PHARMACIST: FOLLOW RESTRICTED USE PROTOCOL DUE TO LIMITED USPPLY

PUBLEHIC HEALTH OFFICIALS: OUTBREAK CONTROL, STRATEGIC ALLOCATION, SONSERVE ANTIVIRALS/

CONFORMED CASES

AG/POULTRY INDUSTRY: ECONOMIC SURIVIVAL AND FOOD SUPPLY STABILITY; OPPOSES

IMMEDIATE LARGE KILL

VET MED: REDUCE VIRAL RESERVOIR, DIAGNOSTICS, BIOSECURITY, CONTRAINMENT AT

ANIMAL SOURCE, EDUCATIONAL OUTREACH,,

ENVIRONMENTAL STAKEHOLDERS: ARGUE KILLING ALONE WILL NOT SOLVE TRANSMISSION

CONSUMERS: FOOD SUPPLY

IDENTIFY PROBLEM (AND DONT BELIEVE YOU BOTH ARE ON THE SAME PAGE)

FRAME (WHO DEFINES IT, ASSUMPTIONS, GOALS/PRIORITIES, CONSTRANTS)

ARTICULATE TRADEOFFS (IF WE PRIORITIZE X, WE WILL SACRIFICE Y)

- NEEDS APPROPRIATE BALANCE WITHOUT PARALYZATION WHO TAKES ACTION

- THEN..who's gonna pay for it

The role of pharmacists in ensuring safe medication use truly resonates with my personal beliefs and practices. This primary responsibility extends beyond merely dispensing medications; it encompasses patient education and engagement. I relate deeply to the emphasis on empowering patients, particularly in fostering medication adherence rather than compliance. Understanding that adherence emphasizes personal commitment aligns with my belief that healthcare decisions should involve the patient actively. This shift encourages better outcomes and promotes a sense of ownership over one's health, which I believe is essential in today's healthcare environment.

Another critical point is the discussion on the complexities involved in problem-solving within healthcare. The speaker's approach to framing problems as gaps between the current and desired states strikes a chord with me. Recognizing not just the apparent medical issues but also the emotional and ethical dilemmas at play is essential. For instance, the challenges faced by healthcare professionals during the COVID-19 pandemic illustrated how healthcare decisions are frequently mired in complex emotional contexts. This highlights the importance of contextual understanding and communication, factors I deem vital in my own practice.

Moreover, the concept of collaboration amongst different demographics in problem-solving is particularly thought-provoking. As the speaker notes, varying perspectives can lead to more comprehensive solutions. I often find myself grappling with the necessity of including diverse voices in discussions surrounding patient care. This aligns with the need for effective stakeholder identification and communication, which is essential for addressing multifaceted healthcare dilemmas. However, it raises questions for me: Are we doing enough to facilitate those conversations? Are we truly listening to the myriad of experiences that different stakeholders bring? These lingering thoughts challenge me to reflect on both my practices and the broader healthcare landscape. Understanding that not all decisions yield clear-cut solutions compels me to approach each situation with an open mind, ready to learn from both successes and failures.

Lastly, the exploration of healthcare problems as multifaceted entities necessitating iterative problem-solving processes continues to whirl in my mind. The acknowledgment that the journey toward resolution may not follow a linear path is essential as a healthcare professional. It leads me to reconsider how I might better approach patient care and engage with my peers, fostering a culture that values continuous improvement and collaboration.

The complexity of decision-making in healthcare is compounded by factors such as lack of knowledge, emotional barriers, and differing perspectives among stakeholders. When approaching problems, it is vital to remain competent and genuinely concerned about discernible gaps to effectively identify and frame issues at hand. For instance, in real-world scenarios, addressing vaccine hesitance during flu season reveals insights into stakeholder priorities, such as individual survival versus public health goals. These dynamics underscore the importance of clearly articulating trade-offs and finding an appropriate balance without causing paralysis, as decisions about who takes action and who bears the costs of those actions become crucial.