PHRM 351 Midterm Help

LECTURE 2

💼 1. Core Management Concepts

Definition: Managing resources (human, financial, physical) to achieve goals efficiently and effectively.
4 Functions → think “P-O-L-E”:

• Planning – goals, strategy, business plan.

• Organizing – allocating staff, budget, workflow.

• Leading – motivating, communicating, coaching.

• Evaluating – reviewing performance, adjusting plans.

🧠 Application tip: If a question says “you’re the pharmacy manager and XYZ happens,” structure your answer around these 4 steps.

👩‍⚕ 2. Leadership vs Management

🧠 Application: “To improve morale, I would use leadership behaviors (recognition, empowerment) while maintaining management structure (clear workflow).”

⚙ 3. Operations & Efficiency

Operations management: turning inputs → outputs efficiently to maximize profit.

Inputs (costs): staff wages, rent, electricity, software, supplies.
Outputs (revenue): prescriptions, OTCs, services, DME.

Formula:
👉 Profit = Revenue – Expenses

Operational efficiency = minimizing waste + maximizing productivity.

🧠 If asked “what would you assess to improve efficiency?” → think: workflow, staffing, inventory, wastage, technology, pricing, service mix.

💰 4. Supply & Demand Basics

• Demand: willingness of consumers to buy.

  • affected by tastes, income, related goods, expectations, # buyers.

• Supply: willingness of producers to sell.

  • affected by resource price, # sellers, expectations, inventory.

• Equilibrium price: where supply = demand.

• WTP (willingness to pay): max price customer will pay → key for pricing clinical services.

🧠 If a scenario asks “why can’t we just raise the dispensing fee?” → mention WTP & competition.

📊 5. Business Fundamentals

Mission = what you do now.
Vision = where you’re going.
Goals = tangible steps to get there.
Values = principles guiding behavior.

🧠 Be ready to craft a sample mission/vision for a pharmacy service (e.g., travel clinic, adherence packaging).

📝 6. Business Plan = Your Roadmap

Know these sections + purpose ↓

🧠 Application: They might say “Design a business plan for a new pharmacy service.” → list these sections with brief content for each.

💡 7. Value Proposition

A clear statement of why customers choose you.
Example: “Our travel vaccine clinic offers same-day appointments and direct billing—saving patients time and stress.”

📈 8. Personal Finance / Math Refresher

They sometimes throw in quick calculations:
Profit = Total Revenue – Total Expenses
Break-Even Point = Fixed Costs ÷ (Price – Variable Cost)

🧠 Example: If each flu shot brings $20 revenue, cost per shot = $8, fixed cost = $2,400 → break-even = 2400 ÷ (20-8) = 200 shots.

🚀 9. Open-Book Exam Strategy

1. Have tabs ready: 4 Ps, POLE, business-plan steps, profit formula, supply & demand.

2. When writing: always anchor to a framework

   • “Using the P-O-L-E framework, I would…”

   • “Based on the 4 Ps, the marketing plan should…”

3. Show insight: include numbers, efficiency examples, or WTP reasoning.

4. ---

   LECTURE 3

💼 1. Core Management Concepts

Definition: Managing resources (human, financial, physical) to achieve goals efficiently and effectively.
4 Functions → think “P-O-L-E”:

• Planning – goals, strategy, business plan.

• Organizing – allocating staff, budget, workflow.

• Leading – motivating, communicating, coaching.

• Evaluating – reviewing performance, adjusting plans.

🧠 Application tip: If a question says “you’re the pharmacy manager and XYZ happens,” structure your answer around these 4 steps.

👩‍⚕ 2. Leadership vs Management

🧠 Application: “To improve morale, I would use leadership behaviors (recognition, empowerment) while maintaining management structure (clear workflow).”

⚙ 3. Operations & Efficiency

Operations management: turning inputs → outputs efficiently to maximize profit.

Inputs (costs): staff wages, rent, electricity, software, supplies.
Outputs (revenue): prescriptions, OTCs, services, DME.

Formula:
👉 Profit = Revenue – Expenses

Operational efficiency = minimizing waste + maximizing productivity.

🧠 If asked “what would you assess to improve efficiency?” → think: workflow, staffing, inventory, wastage, technology, pricing, service mix.

💰 4. Supply & Demand Basics

• Demand: willingness of consumers to buy.

  • affected by tastes, income, related goods, expectations, # buyers.

• Supply: willingness of producers to sell.

  • affected by resource price, # sellers, expectations, inventory.

• Equilibrium price: where supply = demand.

• WTP (willingness to pay): max price customer will pay → key for pricing clinical services.

🧠 If a scenario asks “why can’t we just raise the dispensing fee?” → mention WTP & competition.

📊 5. Business Fundamentals

Mission = what you do now.
Vision = where you’re going.
Goals = tangible steps to get there.
Values = principles guiding behavior.

🧠 Be ready to craft a sample mission/vision for a pharmacy service (e.g., travel clinic, adherence packaging).

📝 6. Business Plan = Your Roadmap

Know these sections + purpose ↓

🧠 Application: They might say “Design a business plan for a new pharmacy service.” → list these sections with brief content for each.

💡 7. Value Proposition

A clear statement of why customers choose you.
Example: “Our travel vaccine clinic offers same-day appointments and direct billing—saving patients time and stress.”

📈 8. Personal Finance / Math Refresher

They sometimes throw in quick calculations:
Profit = Total Revenue – Total Expenses
Break-Even Point = Fixed Costs ÷ (Price – Variable Cost)

🧠 Example: If each flu shot brings $20 revenue, cost per shot = $8, fixed cost = $2,400 → break-even = 2400 ÷ (20-8) = 200 shots.

🚀 9. Open-Book Exam Strategy

1. Have tabs ready: 4 Ps, POLE, business-plan steps, profit formula, supply & demand.

2. When writing: always anchor to a framework

   • “Using the P-O-L-E framework, I would…”

   • “Based on the 4 Ps, the marketing plan should…”

3. Show insight: include numbers, efficiency examples, or WTP reasoning.

🏪 1. Types of Community Pharmacies

You’ll likely be asked to compare types or identify strengths/risks.

🧠 Exam tip: if given a scenario (“You’re asked to open a pharmacy next to a clinic…”), pick a model and justify it by patient flow, cost, and service mix.

💵 2. Income Streams in Pharmacy

💊 A. Clinical Fees

• Dispensing Fee: ~$10 /script (PharmaCare max = $10)

  • Max 3 fees per day (daily), 5 for 2–27 days.

  • Costco ≈ $4.50 vs independent ≈ $13.

• Medication Reviews (MR-S, MR-PC, MR-PCN, MR-F): limits 2 per year total.

• MACS assessments: 86 PINS × $20 each (1 per day max, no MR same day).

• Other: immunizations, refusal-to-fill, adaptations.

• Daily total cap = $78 per patient.

🧠 Application: “How to increase profit ethically?” → maximize eligible clinical services per rules (MR + MACS + immunizations).

📦 B. Markup

Actual Acquisition Cost (AAC) = what the pharmacy paid after discounts/free goods.

Markups:

• Wholesaler markup ≈ 7% → split 5%/2% if paid on time.

• Pharmacy markup (varies by payer):

  • 6% on high-cost (Benefit Plan limits apply)

  • 11% on brand

  • 15% on generic

  • 9% on diabetic supplies

  • Max $250 cap.

🧠 Application: If asked “Why can’t pharmacy raise prices freely?” → mention PharmaCare + 3rd-party limits and WTP (willingness to pay).

💸 C. Professional Allowances & Rebates

• Generic manufacturers give % rebates to encourage brand loyalty.

• Historically 50–60% → now ≈ 10–18% because generic prices fell to 10–18% of brand.

• Common to get “free goods” (BOGO) or discounts → must adjust AAC.

🧠 Exam angle: “Why did generic price cuts hurt pharmacy profit?” → Smaller base price = smaller rebate $ value.

🧾 D. Other Sales

OTC products, cosmetics, snacks → variable markup (often 30–50%).
Helps offset low margins on prescriptions.

🧮 E. LTC Plan B

• Capitation fee ≈ $65 / resident / month covers all dispensing, reviews, delivery.

• High labour for low profit → efficiency critical.

• Also bill compounding + repackage returns (if allowed).

🧠 Scenario cue: “How to stay profitable in LTC?” → improve workflow + minimize waste + maximize MACS fees.

📊 3. Pharmacy Math Formulas and Examples

🧠 Example (Plan C generic):
AAC = $107 → Wholesaler rebate $2 + PA $10 → margin $12 = 11%.
If private plan allows markup $10.70 → total $22.70 = 19%.

📉 4. Gross Margin vs Gross Profit

Overhead includes: rent, utilities, wages, tech, delivery, consumables, fees, marketing, depreciation, loan interest.

🧠 Scenario: “Pharmacy has shrinking profit despite stable sales.” → check delivery costs + inventory waste + staff hours.

💣 5. Challenges & Opportunities

⚠ Challenges

• Fixed dispensing fees since 2011 (no inflation adjustment).

• PharmaCare markup caps + “Full Payment Policy.”

• Delivery not reimbursed (but expected free).

• Generic rebate cuts.

• Rising inventory costs for high-cost drugs (e.g., IUD example = < 2 % margin).

• Audits and clawbacks (PBC, ESC).

🌱 Opportunities

• Add clinical services (MACS, vaccinations, travel medicine).

• Online + telepharmacy expansion.

• Integrate with clinics → shared care models.

• Pharmacist prescribing scope = future growth.

• Health promotion & preventive care.

🧠 Exam application: If asked “How can independent pharmacies stay competitive?” → expand clinical services, optimize operations, use tech, and highlight personalized care.

🚀 6. Open-Book Application Strategy

Use structured answers like:

💵 1. Pharmacy Income Refresher

Lecture 3 left off — how pharmacies actually earn money.

🧾 Income Streams

• Clinical: Dispensing, med reviews, MACS, immunizations, adaptations

• Product Volume: Wholesaler markup (≈7%), pharmacy markup (≈10–15%), professional allowance (rebate)

• PharmaCare limits

  • Doesn’t pay above AAC

  • Full Payment Policy → can’t charge insurer or patient beyond AAC once PharmaCare covers 100%

📊 Examples to Know

• Best Case: established store, strong wholesaler ties, major generic, good insurer coverage → ~36% gross margin

• Worst Case: new/weak relationship, Full Payment Policy applies, minimal rebate → ~11% gross margin

🧠 Application tip:
If a question asks why your pharmacy’s profit is low → mention relationships, payment policy, generic selection, and payer mix (cash vs PharmaCare).

🏛 2. Pharmacy Ownership in BC

✅ Who Can Own

• Sole proprietor, partnership, or corporation.

• Non-pharmacists can own — but most directors must be pharmacists.

• Direct owners = entity on license.

• Indirect owners = directors, officers, shareholders of that entity.

🧠 Scenario angle:
If asked “Can a grocery company own a pharmacy?” → Yes, if pharmacists are majority directors on record (meets PODSA).

🕰 3. History of Ownership Evolution

• Traditionally independent or partnerships.

• Then → owners opened multiple → chains.

• Later → grocery/retail corporations bought pharmacy chains.

🧠 Application:
“Why fewer independents exist?” → corporate consolidation, high startup cost, complex regulation.

🏪 4. Ownership Models — Know These 4

🧠 Exam cue: “Compare banner vs franchise.” → Franchise = fee + strict system; Banner = loose marketing network.

🇨🇦 5. Who Actually Owns Pharmacies in Canada

(% of pharmacy ownership by company type)

• McKesson (Rexall, IDA, Guardian, Medicine Shoppe): ~24%

• Loblaws / Shoppers / Superstore (George Weston Ltd.): ~21%

• Empire (Lawtons / Sobeys): ~4%

• Metro / Jean Coutu: ~6.5%

• Walmart: ~4%

• Costco: ~1%

• Independents & Co-ops: ~20%

• 📈 Online pharmacies (PocketPills, Felix, Pillway) → rapidly increasing share.

🧠 Application:
If asked “Who dominates pharmacy ownership?” → McKesson and Loblaws; consolidation impacts competition and profit margins.

🧩 6. Why Own a Pharmacy?

🧠 Application: “Why do large corporations invest in pharmacy despite low margins?” → foot traffic + cross-sales + vertical integration.

🦃 7. The “Loss-Leader” Concept

• Selling something below cost to bring people in (like $5 turkey).

• Pharmacies are often loss-leaders — low script profit, but high-margin cosmetics, snacks, or private labels.

🧠 Application: “Why might a chain offer flu shots for free?” → increases traffic, loyalty, and OTC sales.

👩‍⚕ 8. Key Roles in a Pharmacy

🧠 Application: “Owner overrules manager’s decision?” → Not allowed for professional matters; CPBC holds manager accountable.

🏗 9. Opening a Pharmacy — Step by Step

A. Site Selection

• Must fit target demographic, traffic, zoning, and service demand.

• Competitive analysis required.

B. Regulatory + Legal Groundwork

• Ensure ownership structure meets PODSA rules.

• Form legal entity (corporation/partnership).

• Secure financing (loans, investors).

C. Municipal Approvals

1. Development Permit – outline operations, hours, services, parking, waste.

   • Includes law enforcement review + background checks.

2. Building Permit – architectural drawings, accessibility, fire/electrical inspections.

3. Occupancy Permit – after passing inspections → allows move-in.

4. Business License – required before Pharmacy License.

D. CPBC & Ministry Steps

• Apply for pharmacy license via CPBC → digital inspection + possible on-site.

• Provide ownership, layout, P&P manual, manager info.

• Register with PharmaNet and PharmaCare (Site ID).

• Register with third-party insurers individually (PBC, ESC, etc.).

🧠 Application: If asked to “outline the process to open a pharmacy,” list municipal → CPBC → PharmaCare → insurer steps in order.

💸 10. Costs Snapshot

Total startup = easily $100K–$500K+

🧠 Exam cue: “What is the J-curve?” → New pharmacies lose money initially; profit only after enough volume and service uptake.

⚠ 11. Common Challenges

🧠 Application: “List 3 major financial risks of owning a pharmacy.” → high fixed costs, reimbursement delays, audit clawbacks.

🌈 12. Benefits & Tips

• Don’t do it alone — partnerships help.

• You can innovate (e.g. travel health, OAT, adherence).

• Choose location wisely.

• Autonomy, flexibility, and career satisfaction are high rewards.

🧠 Quick Recap Formula for Scenario Qs

If the question says:

Structure like:

• Challenges: startup cost ($100K+), audit/insurance complexity, competition from chains.

• Benefits: autonomy, community connection, potential clinical expansion.

LECTURE 4:

💡 1. The Value Framework

🧠 Exam cue: “Why aren’t pharmacists fully valued?” → Because society hasn’t acknowledged or paid for our expertise beyond dispensing.

💎 2. Value Proposition — Pharmacy vs Pharmacist

Pharmacy’s Unique Value Proposition

1. Licensed to stock Schedule I & narcotic drugs

2. Efficient distribution system across BC (rural → urban)

3. Access to regulated professionals without appointment

4. Convenient hours + locations

5. Wide product range (prescription + OTC + behind-counter)

6. Clinical services + private counselling space

Pharmacist’s Unique Value Proposition

1. Medication expertise in therapy optimization

2. Safety oversight & double-check function

3. Prescribing / deprescribing capabilities

4. Medication management & education

🧠 Application: “What’s your pharmacy’s value proposition?” → Accessible medication experts providing safe, evidence-based care that saves time, cost, and healthcare visits.

👥 3. How Others Value Pharmacists

• Public = trusts advice ✅ but expects services free ❌

• Government = recognizes role but limits reimbursement

• Healthcare team = mixed awareness of pharmacists’ expertise

🧠 Scenario tip: If asked “Why are pharmacists undervalued?” → Mention lack of public education + policy support for paid cognitive services.

🚧 4. Barriers to Maximizing Value

1. Reimbursement gaps → few billable services in BC vs AB

2. Time + workload pressure → hard to add new clinical tasks

3. System integration issues → limited record access & collaboration

🛠 5. Enablers (How to Overcome)

🧠 Exam angle: “How could BC improve pharmacist value?” → Adopt AB-style billing, integrated records, fund full-scope services.

🧪 6. Emerging Models of Practice — Pharmacist-Led Clinics

Features:

• Dedicated clinical space + appointments (MOAs support)

• Broad services (MACS, vaccines, minor ailments, chronic disease)

• Integrated with pharmacy or stand-alone

• Data-driven evaluation (show value via metrics)

Evidence to demonstrate value:

of patients served or ER visits prevented

• Patient feedback / satisfaction

• Safety metrics (no complaints under expanded scope)

• Physician and public support

🧠 Application: If asked “How would you prove your clinic’s value?” → Show quantitative (# visits, MACS done) + qualitative (patient stories) evidence.

🗣 7. Advocacy — Your Role as a Pharmacy Student

With Public:

• Raise awareness of pharmacist services

• Run community health screenings

• Educate patients on what pharmacists can bill for

With Government:

• Join CAPSI / BCPhA / CPhA / CSHP

• Meet local MLAs about scope expansion

• Share patient impact stories to demonstrate value

🧠 Open-book shortcut: Write advocacy answers as:

🌱 8. Reimbursable Services in BC (2024 snapshot)

• Dispensing fees: ≈ $10 (max 3–5 per day)

• Med Reviews: MR-S, MR-PC, MR-F (2× / year limit)

• MACS: $20 per assessment (86 PINS)

• Adaptations / Refusal-to-fill / Immunizations: all billable

🧠 Application: “Compare BC and AB models.” → AB = assessment-based payment (per service regardless of Rx); BC = dispensing-focused fee model.

🧩 9. Summary Blueprint

🧠 10. Exam Answer Template for “Application” Questions

Prompt: “How would you demonstrate the value of pharmacists to government?”
Use this formula:

1. Define Value = Acknowledged → Paid → Sustained

2. Show Evidence: data + patient stories + cost savings

3. Advocate: join professional bodies, meet MLAs, promote success stories

Example Answer (ready to paste):

💄 PHRM 351 SPEED-RUN CHEAT SHEET: Lecture 5 — Sales & Marketing in Pharmacy Practice

🎯 1⃣ Core Marketing Concepts

Marketing = communicating and delivering value
Sales = converting that value into action (revenue or behaviour).

🧠 Application cue: “Explain why pharmacists should care about marketing.” → Because it’s how we communicate our professional value and sustain business viability.

🧩 2⃣ The 4 Ps of Marketing (MUST KNOW)

Mnemonic: “Product at the right Place, at the right Price, with the right Promotion.”

🧠 Exam angle: If a scenario describes “extending pharmacy hours to attract working professionals,” that’s Place.

💸 3⃣ Value in Marketing

• Marketing = Value Based Communication.

• Value = what the patient feels is worth paying for.

• Hierarchy of Value → functional (availability) → emotional (trust) → life-changing (health security).

🧠 Example answer line: “Pharmacy marketing focuses on communicating both functional and emotional value — safe medication access and trusted health advice.”

🏥 4⃣ Applying the 4 Ps to Pharmacy Settings

📈 5⃣ Environmental Factors Affecting the Market

• Regulation: PODSA, PharmaCare limits, advertising restrictions

• Technology: e-scripts, telehealth, EMR access

• Economy: recession = lower discretionary spending

• Society: aging pop = ↑ chronic care demand

• Competition: supermarkets, online pharmacies

🧠 If asked “what external forces affect pharmacist marketing,” → name 3 from above.

💬 6⃣ Sales vs Marketing — How They Interact

Marketing builds intelligence → Sales executes it.

• Marketing: identifies audience + promotes service.

• Sales: personal interaction to close (get the appointment or purchase).

🧠 Scenario cue: “A pharmacist speaks to a physician to refer patients for MACS.”
→ That’s a sales interaction using marketing-built materials.

🧠 7⃣ The Sales Cycle (know this in order!)

1. Find leads (patients or partners)

2. Connect (introduce yourself / rapport)

3. Identify needs (“What concerns do you have about your meds?”)

4. Present solution (explain your service)

5. Overcome objections (“It’s free under PharmaCare”)

6. Close the sale (schedule, sign up)

7. Generate referrals (ask for word-of-mouth)

🧠 Apply it to job hunting or vaccines: “Job app = sales cycle: find leads → interview → close offer.”

🛍 8⃣ Four Types of Selling

🧠 Exam trick: If question says “Pharmacist encourages patient to start using blister packs for adherence” → that’s Solution Selling.

⚖ 9⃣ Business Ethics in Pharmacy

Ethics = doing right by patients, staff, & society while meeting business goals.

🔹 3 Factors Influencing Ethical Behaviour

1. Individual values

2. Manager & coworker influence

3. Opportunity / codes / compliance

🔹 4 Main Ethical Categories

🧠 If asked “why employees fail to report misconduct,” → fear retaliation, by-stander effect, no anonymity.

💰 10⃣ Why Sales & Marketing Matter to Pharmacists

• Every pharmacist markets themselves + their services.

• Clinical service success = ability to communicate value and convince stakeholders.

• Used in business plan pitch, interprofessional collaboration, patient counselling.

🧠 Application template:

🧠 11⃣ Open-Book Exam Quick Recall Table

💅 12⃣ Application Question Templates

Q: “Design a marketing strategy for a new pharmacy clinical service.”
A: Use 4 Ps + Value Proposition.

Q: “What type of selling occurs when a pharmacist helps a patient choose an OTC?” → Solution selling.
Q: “How can marketing improve patient care?” → Builds awareness of valuable services → improves access and outcomes.

✅ Bottom Line Summary

• Marketing = strategy. Sales = execution.

• 4 Ps + 4 selling types = automatic marks.

• Ethics questions = 3 influences + 4 categories.

• Application = tie everything back to value, patient benefit, and trust.

♟ PHRM 351 SPEED-RUN CHEAT SHEET

Lecture 6 — Strategic Management & Analysis Tools

🎯 1⃣ What is Strategy & Strategic Management?

🧠 Key idea: Strategy = chess. Always reassess and adapt your moves.

💼 2⃣ Purpose of Strategic Management

• Keeps a business relevant, efficient, and profitable over time.

• Balances short-term goals (e.g. sales targets) with long-term vision (e.g. community trust, service expansion).

• Helps prevent “Blockbuster syndrome” (failure to evolve).

🧠 Application Q Example:

🧱 3⃣ Key Terminology You Must Know

🧠 Exam cue: “Which is long-term vs short-term?” → Vision = long-term; Operations = short-term daily execution.

💡 4⃣ Strategic Tools You Must Know

🧩 A. SWOT Analysis (Internal + External Factors)

Definition: Framework to evaluate where a business currently stands.

Example (Pharmacy Chain):

🧠 When to use: To analyze both internal + external factors and guide decision-making.

🌎 B. PESTLE Analysis (External Macro Factors)

Definition: Used to assess the external environment of a product, business, or service.

🧠 When to use: To understand external influences before launching a new service (e.g. new clinic or program).

⚔ C. Porter’s Five Forces (Competitiveness in Market)

Definition: Analyzes how competitive your market is — determines profitability.

🧠 When to use: To assess market competitiveness and profit potential.

🧠 5⃣ Case Scenarios You Should Know

🩺 Case 1: The Fertility Clinical Program

🧠 Remember:
Porter’s = COMPETITION
SWOT = INTERNAL + EXTERNAL snapshot
PESTLE = MACRO-level context

🧭 6⃣ Exam Application Strategy

Typical Question Format:

Answer framework (3 lines):
1⃣ Identify goal → internal vs external vs competitive.
2⃣ Match tool (SWOT, PESTLE, or Porter’s).
3⃣ Justify with short rationale.

✅ Example Answer:

🧱 7⃣ Summary Chart (for open-book quick scan)

🧠 8⃣ How to Write a Strong Application Answer

Step-by-step mini template:

1. Identify the goal (analyze, plan, or compete).

2. Name the framework/tool.

3. Apply to a pharmacy example.

4. Tie to value (efficiency, competitiveness, sustainability).

🧠 Example:

🏁 9⃣ Key Takeaway

• Strategic management = adaptability.

• SWOT = where are we now?

• PESTLE = what’s happening around us?

• Porter’s = who are we competing with?

→ Together, they form your pharmacy’s business “GPS.”

LECTURE 7

🧠 1⃣ Big Picture

Goal: Understand how to develop and sustain an innovative pharmacy idea through structured analysis (PIRP + PESTEL) and effective collaboration.
Theme: You can’t innovate in isolation — you need data, resources, and people.

🍽 2⃣ PIRP Framework = Innovation Recipe

🧩 Mnemonic: PIRP = “Pause If Ready Please.”
💡 Use it any time you need to plan a new service (e.g., travel clinic, mental-health screening, etc.).

🧭 3⃣ P = Pause (Reflection Stage)

• Take a breath before acting.

• Assess state of mind + motivation.

• Evaluate confidence vs importance (readiness matrix).
  ✅ Tip: If confidence low but importance high → seek mentorship or training first.

🔍 4⃣ I = Information (Gathering Stage)

Sources:

• Peer-reviewed literature, grey literature (white papers, conference abstracts, policy reports, blog posts).

• Google Scholar, government reports, organizational documents.
  Evaluate 3 things:

1. Availability (coverage & scope)

2. Reliability (consistency & trustworthiness)

3. Validity (accuracy & relevance)

⚠ AI outputs can look “workslop” – always cross-check!

⚙ 5⃣ R = Resources (What You Have + Need)

Personal Effectiveness Resources

1. Time ⏰ – finite; allocate strategically.

2. Energy 🔋 – renewable; balance and rest.

3. Attention 🎯 – focus on what matters.

4. Grit 💪 – keep pushing through challenges.

External Resources

• Professional groups (CAPSI, BCPhA, CPhA).

• Foundations / charities 💰 – funding and support.

• Community engagement 🏘 – partnerships and volunteers.

• Funding sources: personal funds → grants → investors → in-kind support (space, equipment, mentorship).

👥 6⃣ P = People (Network Stage)

Who They Are

Patients | HCPs | Organizations | Friends & family | Leaders | Payers | Cross-sector partners

How to Find Them

• Ask for opinions/advice.

• Attend meetings & conferences.

• Grab coffee chats.

• Join interest groups.

• Volunteer / introduce people / follow up.

Are You a Connector?

✅ Remember names, like people, build relationships, share info.
Networking = deliberate effort to connect with purpose.

💬 7⃣ Partner Engagement Principles

Goal: Partners with purpose — mutual benefit + shared vision.

Potential Partners: patients, HCPs, managers, religious groups, local employers, community organizations.
✅ Mutual benefit + complementary skills = sustainable collab.

📜 8⃣ Core Values for Public Participation (IAP2 Framework)

Main Idea: People affected by decisions have a right to be involved.
7 Core Values (short version):

1. Those affected must be involved.

2. Their input should influence decisions.

3. Recognize and balance all stakeholder needs.

4. Seek and facilitate involvement of all affected.

5. Let participants help shape the process.

6. Provide enough info for meaningful input.

7. Show how input impacted final decision.

🧠 Exam cue: If they ask “How should pharmacists engage the public ethically?” → cite IAP2 core values + mutual decision-making.

🌎 9⃣ PESTEL Analysis (aka Situational Scan)

🧠 Use PESTEL to analyze context before launching a project or writing a business plan.

🧩 🔟 Case Examples (High-Yield)

🧠 11⃣ Exam Application Cheat Codes

💅 12⃣ Rapid Recall Summary

✅ Bottom Line:
To innovate in pharmacy, first pause and analyze your environment (PESTEL), then use PIRP to mobilize resources and partners who share your purpose. Continuous feedback = sustained success.

LECTURE 8

👨‍⚕ 1⃣ Who is David Graham?

• Founder and pharmacist who opened Graham’s Pharmacy in 2012 in Kingston.

• Previously worked as a salaried pharmacist in chain stores → saw depersonalized, high-volume culture.

• Values: patient-centred care 💖, clinical assessment over mechanical dispensing, long-term relationships, preventative health.

• Vision: bring back the “traditional” neighbourhood-pharmacy model but integrate modern services.

🧠 Exam cue: If asked “What differentiates Graham’s Pharmacy?”, say → strong relationship-based model + specialized clinical focus (e.g., diabetes, hypertension).

🏪 2⃣ Business and Marketing Environment

• Competing with big-box chains (Shoppers, Costco, Loblaws).

• Serves a mixed population (seniors, students, military, local workers).

• Focus on preventative and chronic care services that chains don’t offer.

🧠 Use PESTEL phrasing if asked about external environment.

🧾 3⃣ Mission Statement (iClicker Example)

💡 Keep it values-aligned, short, and impact-focused.

💪 4⃣ SWOT Analysis (Situation Assessment)

🧠 Exam cue: “Which SWOT factor is internal?” → Strengths & Weaknesses (inside the pharmacy).

🧮 5⃣ Economies of Scale

🧠 Smaller independents like Graham rarely reach external economies of scale, so they must focus on quality differentiation instead of price.

🧩 6⃣ Market Segmentation & Targeting

🧠 If asked about market segmentation: link service offerings to unique demographic needs.

💊 7⃣ Marketing Mix (4 Ps in Action)

🧠 Loss Leader Strategy: offer free clinics or delivery to increase traffic and loyalty (like Costco hot dogs 🌭).

💬 8⃣ Relational vs Transactional Approach

🧠 Application prompt: “How does Graham’s pharmacy create a relational advantage?” → Consistent communication, personalized care, long-term trust.

📈 9⃣ Growth and Outcomes

• Expanded to 3 locations since 2012.

• Rebranded as Diabetes Specialty Centre.

• Free hypertension/diabetes clinics and delivery service.

• Majority of reviews = positive (“go above & beyond”).

🧠 Sustained advantage = differentiation + mission alignment + consistent value.

🧠 🔟 Exam Application Templates

Q: “Identify two marketing strategies that help Graham’s Pharmacy stay competitive.”
A: 1⃣ Focus on relationship-based care (Strength + Differentiator) → builds loyalty and referrals.
2⃣ Offer value-added services like diabetes education and free delivery → enhances access and retention.

Q: “Which market segment should Graham prioritize?”
A: Older adults with chronic diseases since they require continuous management and generate repeat business.

💡 Summary

• Graham’s Pharmacy survives in a competitive market by differentiating on care quality and relationships, not price.

• Core frameworks: 4 Ps, SWOT, Segmentation, Relational Marketing.

• Every decision aligns with his mission & values.

LECUTRE 9

💰 1⃣ Four Paths to Pharmacy Ownership

🧠 Application: “Which model best suits a risk-averse pharmacist?” → Franchise or buy-in (shared support, less financial exposure).

💸 2⃣ Anatomy of a Deal — Beyond the Sticker Price

Starting/buying costs include more than the purchase price!

Hidden Costs to Budget For

• Legal & accounting fees

• Renovations, permits, licensing

• Staff hiring/training

• Inventory purchases

• Cash buffer for 6–12 months of operations

✅ Pro tip: Always add a 15–20% contingency fund.

🏦 3⃣ Funding Options

🧾 4⃣ The 5 C’s of Credit (Lender Risk Assessment)

🧠 Application: “If a bank rejects a loan, which C might be weakest?” → depends: poor credit = Character, low DSCR = Capacity.

📊 5⃣ Debt Service Coverage Ratio (DSCR)

Definition: Measures ability to repay loans from cash flow.

Formula:

DSCR=Net IncomeAnnual Debt Service\text{DSCR} = \frac{\text{Net Income}}{\text{Annual Debt Service}}DSCR=Annual Debt ServiceNet Income​

• Lenders want ≥ 1.25× (you earn 25% more than what’s needed for debt payments).

🔧 How to Improve DSCR

• ↑ Net income: increase revenue, reduce expenses

• ↓ Annual debt service: extend amortization, refinance, reduce interest rate

• Add equity (your own funds)

🧠 If DSCR < 1.25: You’re too risky — bank may deny or require larger down payment.

🧠 6⃣ The Business Plan Roadmap (Your “Pitch Deck” for Lenders)

Purpose: To prove you’ve thought of every angle + can manage risk.

Key Sections:

1. Executive Summary

2. Company Description

3. Market Analysis (SWOT, PESTEL, demographics)

4. Services & Products (e.g. travel clinic, diabetes program)

5. Marketing & Sales Strategy (4 Ps)

6. Management Team (your experience & partnerships)

🧠 Tip: Banks care less about passion, more about numbers and risk mitigation.

🧾 7⃣ Steps to Getting Approved

1⃣ Check your credit score + organize personal finances
2⃣ Build a solid business plan
3⃣ Pre-application: talk to multiple lenders (compare rates)
4⃣ Submit full package (financials, resume, credit history)
5⃣ Bank does underwriting & due diligence
6⃣ Get approval → commitment → funding

⚠ 8⃣ Common Financial Pitfalls

🧠 Exam trick: “You can be profitable on paper and still fail.” → Poor cash flow.

💼 9⃣ Case Studies

💵 10⃣ Personal Financial Literacy (for Pharmacists)

Why it matters: high student debt + steady income = opportunity for wealth building.

Core Principles

1. Spend less than you earn 💰

2. Pay yourself first (10–20% savings)

3. Avoid bad debt

4. Invest early & consistently

5. Protect income and health (insurance)

🧠 “Pay yourself first” = automate savings before spending.

🏦 11⃣ Emergency Fund

• 3–6 months of living expenses

• Keep in high-interest savings account

• Shields you from job loss or medical emergencies

📈 12⃣ Investing Basics

💡 Key Strategy: Diversification

Don’t try to time the market → Dollar Cost Averaging (DCA)

• Invest a fixed amount regularly (monthly)

• Smooths volatility and builds consistency

💰 13⃣ Registered Accounts

🧠 Exam phrase: “RRSP = tax deferred, TFSA = tax free.”

⚖ 14⃣ Taxes & Financial Planning

• Pharmacists often hit high income brackets

• Max RRSP + TFSA to reduce tax burden

• Claim eligible professional or education expenses

• Work with a tax professional early

• Review financial plan yearly

🧠 15⃣ Common Investing Pitfalls

• Emotional decisions (media panic or FOMO)

• Too much or too little risk

• Not having a process

• Forgetting to rebalance portfolio

🧩 Warren Buffett quote: “Be fearful when others are greedy, and greedy when others are fearful.”

🌈 16⃣ Roadmap to Financial Freedom

1. Build emergency fund

2. Pay yourself first (automate savings)

3. Pay down bad debt

4. Invest consistently (DCA)

5. Use registered accounts (RRSP, TFSA, FHSA)

6. Review goals annually

✅ Bottom Line Summary

• Banks care about DSCR, character, and capital.

• Financial literacy = long-term independence.

• Business plan = your ticket to approval.

• Cash flow management beats profit on paper.

👩‍💼 1⃣ What is Human Resources Management (HRM)?

Definition:
Strategic approach to managing people effectively — optimizing recruitment, performance, and satisfaction to give a competitive advantage.

💡 HRM = Managing the hearts & minds of your team

Even the best strategy or tech fails without motivated people.

🧱 2⃣ Functions of HRM

🧠 Application tip: In pharmacy, HR functions directly affect patient care quality and workflow efficiency.

🧍‍♀ 3⃣ Hiring: Finding the Right Person for the Job

✅ Employer Perspective — 7 Cs:

1. Competent – right skills/experience

2. Capable – growth potential

3. Compatible – team fit

4. Committed – longevity

5. Character – integrity

6. Culture fit – aligns with company values

7. Compensation – satisfied with pay

👩‍⚕ Employee Perspective — 7 Cs (reverse view):

• Competent & Capable coworkers, commitment from employer, fair pay, shared values

🧠 Scenario:
If a new tech is competent but not compatible → short-term gain, long-term turnover risk.

🚀 4⃣ Onboarding (Organizational Socialization)

Definition: The process of integrating new hires into workplace culture & expectations (≈ first 90 days).

The 4 C’s of Onboarding

✅ Outcomes of good onboarding:

• ↑ Job satisfaction

• ↑ Performance & retention

• ↓ Stress & turnover

🧠 Application tip: Poor onboarding = poor performance + faster burnout.

🧩 5⃣ Work Culture

Definition: Formal & informal norms, attitudes, and behaviours shaping workplace interactions.

🔹 Strong Culture = Better Everything

• ↑ Retention & job satisfaction

• ↓ Absenteeism

• ↑ Team collaboration, efficiency, patient satisfaction

• → Better health outcomes

🧠 Scenario: “Describe how COVID changed pharmacy work culture.”
→ Greater awareness of pharmacist roles + teamwork challenges (masking, high stress).

💬 6⃣ Motivation in the Workplace

🔸 Intrinsic Motivation = internal satisfaction

• Purpose, curiosity, autonomy, belonging

• Examples: meaningful work, recognition, respect, trust

🔸 Extrinsic Motivation = external rewards

• Money, promotions, benefits, praise, job security

✨ Balanced Teams Need Both

• Everyone’s motivators differ — combine intrinsic + extrinsic strategies.

🧠 Pharmacy Case (Mr. Grumpy)

💡 Application tip: For patients, intrinsic motivation often drives long-term adherence.

⚔ 7⃣ Conflict Management

Conflict = inevitable but not always bad → promotes alignment & understanding if handled well.

Conflict Styles

💡 The 5-Step Collaboration Model

1⃣ Identify the problem (root cause)
2⃣ Brainstorm solutions
3⃣ Choose best compromise
4⃣ Plan implementation
5⃣ Evaluate outcome & adjust

🧠 Scenario example:
Staff pharmacist (Jordan) feels underpaid after new service launch → collaborate: assess revenue growth, propose incremental raise or profit-sharing, and follow up.

⚖ 8⃣ Employment Standards Act (BC)

Purpose: To protect workers and ensure fairness.

✳ 6 Core Purposes

(a) Guarantee basic compensation & work conditions
(b) Promote fair treatment
(c) Encourage open communication
(d) Provide dispute resolution
(e) Build a productive labour force
(f) Support work–family balance

🧠 Application: “How does the ESA affect pharmacy employers?”
→ Must follow minimum wage, hours, overtime, and leave laws to stay compliant and retain staff ethically.

💡 9⃣ Quick Recall Table

🧠 10⃣ Open-Book Exam Phrases to Drop

• “Strong HRM = sustainable operations and improved patient outcomes.”

• “Balance intrinsic and extrinsic motivators for optimal performance.”

• “Conflict isn’t inherently bad; collaboration fosters mutual growth.”

• “Onboarding success predicts long-term engagement and retention.”

• “The Employment Standards Act ensures fair treatment and productive labour.”

✅ Bottom Line Summary

• HRM = PEOPLE STRATEGY — it’s how pharmacies keep teams motivated, compliant, and effective.

• Hiring, onboarding, and culture define performance quality.

• Strong motivation and conflict management build resilient pharmacy teams.

LECTURE 11 + 12

🏥 1⃣ Overview: What Defines a Hospital Pharmacy?

• Not-for-profit, designated by provincial government under the Canada Health Act.

• Provides inpatient and outpatient care.

• Managed by BC Ministry of Health through 6 Health Authorities:
  Fraser, Interior, Northern, Vancouver Coastal, Island, First Nations, and Provincial Health Services.

Types:

• General, Specialized (Cancer, Cardiac), Chronic/Long-Term, Rehabilitation, Mixed.

🧠 Exam cue: If asked “What makes hospital pharmacy unique?” → team-based care, centralized formulary, and system-level decision-making.

🧾 2⃣ Accreditation Canada

• Independent, non-governmental org that evaluates hospitals for quality and safety.

• Uses Health Standards Organization (HSO) frameworks.

• Provides recommendations for improvement.
  💡 Think: “External peer review” ensuring safe processes and continuous quality improvement (CQI).

💊 3⃣ Formularies & Drug Use in Hospitals

Why meds change from admission → discharge: hospital formulary ≠ community formulary.
→ e.g. a patient’s SGLT2i may be switched to metformin if non-formulary.

🧠 Application: “Why might a patient’s medication change during hospitalization?” → formulary restriction, clinical substitution, safety, or cost optimization.

🧩 4⃣ Lower Mainland Pharmacy Services (LMPS)

• Oversees distribution + clinical pharmacy operations across hospitals.

• 1 Executive Director → 10 Directors → Coordinators/Managers → Frontline staff.

• Coordinators do most hiring, scheduling, and liaison work between leadership and staff.

LMPS Departments:

• Clinical

• Distribution

• Informatics & Automation

• Supply Chain

• Medication Use Evaluation

• Quality & Medication Safety

• Production Centres (sterile compounding)

🧠 Exam tip: “Which branch handles Pyxis or IV rooms?” → Informatics/Automation or Production.

🧠 5⃣ Leadership vs Management

💬 Slido answer themes:

• Leader: Inspire, empower, innovate

• Manager: Delegate, supervise, ensure quotas

🧠 Key phrase to drop: “Leaders drive purpose; managers drive performance.”

💪 6⃣ Core Leadership Qualities

✨ Vision, Integrity, Courage, Self-Awareness, Emotional Intelligence.

• Leadership starts with self-leadership (“The first person you lead is yourself”).

• Values = compass for behaviour → influences motivation, decisions, and fulfillment.
  💡 Use Brené Brown’s values list to identify top 3 guiding principles (e.g., compassion, accountability, growth).

⚡ 7⃣ Power Bases

🧠 Most effective powers: Referent, Expert, Connection → relational & trust-based.
⚠ Least effective: Coercive (fear-based) — breeds resentment.

🧰 8⃣ Leadership Toolbox

💡 Application: “How could you apply ADKAR to rolling out a new EMR?” → Build awareness and ability through training and reinforcement.

🏥 9⃣ Hospital Pharmacist Roles

🧠 “Describe a day in the life of a clinical pharmacist” → Admission, care planning, rounds, discharge reconciliation, patient teaching.

🎓 10⃣ LMPS Residency Program

Structure:

• 1-year program (June–May) with adult + pediatric pods.

• 17 spots total (2026/27 cycle).

• Application window: mid-Aug → early Oct.

• Interviews Dec → Match Jan.

• Start June.

Tips:

• Diverse experiences (volunteering, work, research, leadership).

• Strong references from different roles (e.g. preceptor, manager, volunteer lead).

• During interview → combine “why you want residency” + “how your experiences prepared you.”

💬 Key quote: “Don’t let impostor syndrome stop you from applying.”

🧑‍⚕ 11⃣ Interprofessional Collaboration

Definition: Shared decision-making among HCPs for optimal patient outcomes.

💡 Team Members

Pharmacists, physicians, nurses, dietitians, OTs/PTs, social workers, residents, students.

Pharmacist Contributions:

• Drug therapy expertise

• Medication reconciliation

• Preventing adverse events

• Educating staff & patients

• Advocating for medication safety

Benefits of Collaboration:

• ↑ Safety

• ↑ Patient satisfaction

• ↓ Readmission rates

• ↑ Job satisfaction & professional respect

🧠 Scenario example: “How can pharmacists strengthen interprofessional collaboration?”
→ Active participation in rounds, communicating therapeutic rationale clearly, mutual respect.

💼 12⃣ Unions & Employment Structures

⚖ Pros & Cons of Unionization

🧠 Key takeaway: Unions = stability + fairness, but at the cost of flexibility & autonomy.

🤖 13⃣ Future of Hospital Pharmacy

• Scope expansion (prescribing, primary care integration)

• Shift toward outpatient / ambulatory models

• Automation & AI

• Cultural safety and EDI integration

• Pharmacogenomics & gene therapy services

💬 Exam cue: “What trends will shape the future of pharmacy practice?”
→ Technology + expanded scope + interdisciplinary care.

👩‍🔬 14⃣ Pharmacy Technicians & Assistants

🧠 Technicians = regulated, Assistants = support staff.

💡 15⃣ Open-Book Key Phrases to Drop

• “Leaders inspire; managers execute.”

• “Referent and expert power are most effective for clinical leadership.”

• “Hospital pharmacy is defined by interprofessional collaboration and formulary governance.”

• “ADKAR enables successful change implementation.”

• “Unionization provides job security and structured professional growth.”

✅ Bottom Line Summary

• Hospital pharmacy = structured, regulated, and team-oriented.

• Leadership & collaboration = essential for effective patient care.

• Success in hospital practice = balancing management, communication, and clinical expertise.

LECTURE 15

👑 1⃣ Leadership vs Management

🧠 Exam cue: Leaders inspire change → Managers stabilize it. Both are needed in pharmacy.

💫 2⃣ Core Leadership Qualities

• Judgment = #1 predictor of effective leadership

• Character + Competence = Trust

• Integrity, Vision, Empathy, Courage, Authenticity shape leadership style

💬 Key insight: Organizations must embed character into their systems and model it through role leaders.

💼 3⃣ Leadership in Practice – Pharmacy Application

Inspired by Brian Niccol (Chipotle → Starbucks) ☕
Pharmacies can adapt these principles:

🔹 Operational Efficiency

• Track performance → identify underperforming services

• Streamline workflow → focus on value-driving activities

• Reallocate resources strategically

🔹 Invest in People

• Offer competitive pay + growth opportunities

• Recognize achievements & celebrate wins

• Foster a supportive culture → build loyalty

🔹 Clear Communication

• Communicate vision transparently

• Ask for feedback → build trust

• Align messaging with values and mission

🔹 Growth with Discipline

• Expand only when ready (e.g., add services gradually)

• Quality > quantity — never sacrifice standards

• Balance innovation with patient trust

🧠 Application Q: “How can pharmacy owners apply Niccol’s strategies?” → Combine clear strategy + people-first culture + operational discipline.

🌱 4⃣ Growth Mindset vs Fixed Mindset

How to Shift to Growth Mindset 🧩
1⃣ Tell yourself a different story (reframe failure as feedback)
2⃣ Set learning goals instead of outcome goals
3⃣ Capitalize on failures → analyze & adjust
4⃣ Choose “Goldilocks” tasks (not too easy or hard)
5⃣ Be consistent yet flexible

🧠 Exam cue: Growth mindset = adaptability & resilience → key for leaders and change agents.

💞 5⃣ Emotional Intelligence (EQ)

💡 High EQ = better communication, conflict resolution, and leadership presence.

🧠 Application Q: “How does EQ enhance leadership in pharmacy?” → EQ builds trust and team resilience under pressure (e.g., busy flu season).

🔍 6⃣ Authentic Leadership & Values

• Know your motivational drivers and strengths.

• Understand your communication style.

• Adapt your approach to team needs.

• Reflect on your core values — what do you stand for?
  🧠 Exam cue: “Authentic leadership builds trust through consistency and self-awareness.”

🔄 7⃣ Change Management

Definition: Structured process helping people understand, commit to, accept, and embrace change.

💡 Why Change is Necessary

• Embrace innovation (e.g., automation, Script-Pro)

• Improve business results (add-on sales)

• Reduce resistance & increase engagement

• Enhance patient outcomes (e.g., vaccination programs)

• Reduce costs

⚠ Challenges

• Resistance to change (common & emotional)

• Internal politics or team dysfunction

• Ambiguity & uncertainty

• Feedback to leadership can be hard

🧩 8⃣ The ADKAR Model

A → Awareness — Recognize why change is needed
D → Desire — Motivation to support change
K → Knowledge — Know how to change
A → Ability — Apply skills & behaviours
R → Reinforcement — Make it stick through feedback & celebration

🧠 Exam Scenarios:

• Biologic → Biosimilar Switch

  • A: Need (cost savings) D: Support (patient education) K: Process A: Injection tech R: Follow-up.

• Schedule Change in Pharmacy

  • A: Reality of automation D: Job security K: New workflow A: Trial run R: Debrief & reinforce benefits.

💡 ADKAR = practical tool for pharmacy leaders guiding staff through change.

🧠 9⃣ 7 Components of Successful Change Management

1⃣ Make the case for change
2⃣ Have a compelling vision
3⃣ Communicate the process
4⃣ Manage barriers
5⃣ Address resistance
6⃣ Show progress & early wins
7⃣ Adjust and adapt

🧩 Example Q: “How would you apply ADKAR to rolling out automation in a pharmacy?” → Awareness (training need) → Desire (focus on benefits) → Knowledge (training plan) → Ability (practice sessions) → Reinforcement (recognition + feedback).

💬 10⃣ Communication in Change

“The 5 Wonders of Change” → Who, What, Why, How, What If?
Clarity and transparency reduce resistance and build trust during transitions.

🧩 11⃣ Exam-Ready Phrases

• “Leadership is about character, not title.”

• “EQ enhances trust, team morale, and conflict resolution.”

• “Growth mindset leaders turn failure into feedback.”

• “ADKAR translates change from concept to practice.”

• “Communication and reinforcement cement lasting change.”

✅ Bottom Line Summary

• Leadership = vision + character + EQ.

• Growth mindset = adaptability & learning.

• Change management = ADKAR + communication + resilience.

• Successful leaders build trust, empower teams, and turn change into opportunity.

LECTURE 16

🚨 1⃣ The Core Problem

Riverside Hospital (RDMH) is a small rural hospital with frequent medication errors causing patient harm.
Goal: improve medication safety and ensure sustainable pharmacy services with limited resources.

🧠 Exam cue: “What’s the main problem?” → Unsafe medication processes + under-resourced system = high risk of preventable harm.

⚠ 2⃣ Questionable Practices

🧠 Application Q: “Which practice poses the greatest risk?” → Lack of pharmacist verification + handwritten processes (system-level error).

💬 3⃣ Stakeholder Concerns

🧠 Exam cue: “Why is stakeholder engagement key?” → It aligns operational, ethical, and community perspectives to create sustainable change.

🧱 4⃣ Root Causes of the Problem

• Understaffing: part-time pharmacists only → limited oversight.

• Manual processes: handwritten & transcribed multiple times.

• Cost-cutting culture: prioritizing short-term savings over safety.

• Lack of automation: no barcode/dispensing systems.

• No 24/7 coverage: zero after-hours pharmacy access.

💡 Underlying theme: System failure → not individual error.

🎯 5⃣ Medication Safety Goals

1⃣ Reduce adverse events linked to medication use.
2⃣ Achieve 24/7 pharmacy coverage (direct or remote).
3⃣ Build sustainable pharmacy operations.
4⃣ Foster a safety-oriented culture (not blame-based).

🧠 Phrase drop: “Medication safety = system reliability + human accountability.”

⚙ 6⃣ Strategic Options

🧠 Feasibility Answer:

• Best choice: A (Unit Dose) = affordable + effective for rural hospital.

• B ideal for long-term goal if funding improves.

• C not realistic (too expensive).

• D = last resort (loss of autonomy + slower service).

📊 7⃣ Implementation Plan (Step-by-Step)

Phase 1 — Plan

• Engage stakeholders (board, pharmacy staff, nurses, techs, patients).

• Define success metrics: ↓ error rate, ↑ patient satisfaction.

• Secure funding + set timeline.

Phase 2 — Execute

• Train staff on new system.

• Pilot unit-dose rollout in one ward first.

• Create reporting process for med errors.

Phase 3 — Evaluate

• Track pre- vs post-error rates.

• Hold feedback sessions.

• Adjust workflow and communication lines.

Phase 4 — Reinforce

• Continuous training + leadership accountability.

• Celebrate early wins (ADKAR Reinforcement).

⚖ 8⃣ Risk Management & Contingency Plan

🧠 Plan B: integrate with another hospital’s pharmacy for remote verification while building capacity locally.

💼 9⃣ Evaluating Impact

💡 Measurement criteria: # of reported errors, patient recovery times, staff satisfaction, turnaround time for med delivery.

🧠 🔟 Exam Application Templates

Q: “Which system should Riverside adopt and why?”
A: Unit Dose System → balances cost, safety, and feasibility. Reduces transcription errors and ensures traceability. Supported by literature as a proven safety intervention.

Q: “What factors led to unsafe practices?”
A: Cost-cutting culture, limited pharmacist staffing, handwritten orders, lack of automation, and insufficient safety checks.

Q: “How would you manage resistance to change?”
A: Use ADKAR: build awareness (safety urgency), desire (staff involvement), knowledge (training), ability (pilot project), reinforcement (feedback & recognition).

Q: “What are the long-term strategies for sustainable hospital pharmacy services?”
A: Integrate tech, ensure 24/7 pharmacist access (remote or in-person), and establish a non-punitive safety reporting culture.

💬 11⃣ Key Phrases to Drop in Written Answers

• “Medication errors reflect system-level failures, not individual incompetence.”

• “Patient safety requires a balance of cost control and ethical responsibility.”

• “Stakeholder collaboration is vital for sustainable healthcare innovation.”

• “ADKAR framework supports behavioural change and culture reinforcement.”

• “Continuous quality improvement (CQI) ensures that safety evolves alongside efficiency.”

✅ Bottom Line Summary

• Riverside’s crisis = underfunding + unsafe shortcuts.

• Solution = feasible safety systems (Unit Dose) + leadership-driven culture change.

• Use systems thinking, risk management, and ADKAR to build sustainable, safe pharmacy operations.

Lecture 13 — Budget, Cash Flow, and Profit Explained

🧾 1⃣ PROFIT BASICS

Definition:

🔹 Why It Matters

• Measures business success and efficiency.

• Attracts investors.

• Provides capital to expand or sustain business.

• Drives sustainability and growth.

💸 2⃣ 3 TYPES OF PROFIT

🧠 Exam cue: “Which metric best reflects efficiency?” → Operating profit.
“Which metric determines ROI?” → Net profit.

☕ 3⃣ CUSTOMER VALUE (WTP)

Willingness to Pay (WTP) = perceived value by customer.

• Starbucks captures more WTP with size options, upselling, non-coffee items.

• Higher WTP → higher gross margin.

🧩 Gross Margin Formula:

Gross Margin %=Revenue – COGSRevenue×100\text{Gross Margin \%} = \frac{\text{Revenue – COGS}}{\text{Revenue}} \times 100Gross Margin %=RevenueRevenue – COGS​×100

💡 Example:
Sell drug for $50, costs $30 → GM% = (50 – 30)/50 × 100 = 40%.

🧮 4⃣ RETURN ON INVESTMENT (ROI)

Measures profitability of an investment.

ROI %=Net ProfitPurchase Price or Investment×100\text{ROI \%} = \frac{\text{Net Profit}}{\text{Purchase Price or Investment}} \times 100ROI %=Purchase Price or InvestmentNet Profit​×100

💡 Example:
You buy a pharmacy for $1,000,000 → annual net income = $50,000.
ROI = 50,000 / 1,000,000 × 100 = 5%.

🧠 Shortcut concept:
If P/E ratio = 24 → ROI = 1 ÷ 24 = 4.2%

💰 5⃣ COMPOUNDING POWER (aka “time = money”)

A=P(1+r)tA = P(1 + r)^tA=P(1+r)t

where:

• A = final amount

• P = principal

• r = annual rate (decimal)

• t = time (years)

💡 Example:
Invest $10,000 at 6% for 5 years → A = 10,000(1.06)^5 = $13,382.

💵 6⃣ CASH FLOW BASICS

🔹 Why it matters:

• Even if a business is “profitable,” it can fail if cash runs out (for payroll, rent, inventory).

🧩 Example:
Merck has:

• +$13B operating cash

• –$16B investing cash
  Needs ≈ +$3B financing to balance flow.

🧾 7⃣ CASH FLOW VS PROFIT DIFFERENCE

🧠 Profit ≠ Cash. Income statements show accrual (earned), not actual money available.

💵 8⃣ BREAK-EVEN POINT

Break-even Units=Fixed CostsPrice per unit – Variable cost per unit\text{Break-even Units} = \frac{\text{Fixed Costs}}{\text{Price per unit – Variable cost per unit}}Break-even Units=Price per unit – Variable cost per unitFixed Costs​

💡 Example:
Fixed cost = $10,000 (ads)
Price = $40; COGS = $30
→ Break-even = 10,000 / (40 – 30) = 1,000 units

🧠 If they ask “how many more units to make profit?” — any sales above 1,000.

🧾 9⃣ BUDGETING

Key points:

• Combines forecasting (art) + analysis (science).

• Helps plan new ventures or evaluate expansion feasibility.

• Monitors revenue vs cost vs time.

🧠 Application: They might show a small “cash flow forecast” table → your task is to determine in which year it turns positive (often Year 3).

💼 🔟 CANADIAN TAX BASICS

🔹 Personal Tax Brackets (BC 2025)

• Low income (<$50K) → ~20–25%

• Typical pharmacist ($100–130K) → ~38–42%

• > $259K → 53.5%

🔹 RRSP (Registered Retirement Savings Plan)

• Contributions reduce taxable income.

• Example: $130K salary – $10K RRSP = taxed on $120K.

• Refund = $10,000 × 38% = $3,800 refund.

• Grows tax-free but withdrawals are taxed later.

🔹 TFSA (Tax-Free Savings Account)

• 2025 limit = $7,000/year (lifetime $109,000).

• Growth & withdrawals = 100% tax-free.

• Best for flexibility or low-income years.

🧠 RRSP vs TFSA Rule:
If income > $50K → RRSP.
If < $50K → TFSA.
Employer matching = always RRSP.

🧮 11⃣ CORPORATE TAXES

💡 LCGE – Lifetime Capital Gains Exemption

• When selling a small business, first $1M of gains are tax-free.

• Encourages ownership & entrepreneurship.

🧠 12⃣ KEY FINANCE FORMULAS (FULL CHEAT SHEET)

🧮 13⃣ “PLUG-AND-CHUG” EXAMPLE SCENARIO

Scenario:
You open a compounding pharmacy.

Step 1 — Gross Profit

= (60 – 35) × 5,000 = $125,000

Step 2 — Operating Profit

= 125,000 – 100,000 = $25,000

Step 3 — Net Profit

= 25,000 – 20,000 = $5,000

Step 4 — ROI

Investment = $100,000 startup → ROI = 5,000 ÷ 100,000 × 100 = 5%

Step 5 — Break-Even

= 100,000 ÷ (60 – 35) = 4,000 prescriptions

🧠 You must sell >4,000 Rx to be profitable.

💡 14⃣ How to Answer Written Questions

• Define the concept first.

• State formula clearly.

• Plug in numbers step-by-step.

• Interpret results (“Therefore, ROI = 5%, meaning the investment is modestly profitable but low risk.”)

✅ Bottom Line Summary

• Profit ≠ cash flow → learn both.

• Know Gross / Operating / Net profit distinctions.

• Memorize ROI, Break-Even, Gross Margin, Cash Flow formulas.

• RRSP → reduces tax; TFSA → tax-free growth.

• Small business → 11% corporate tax rate; LCGE protects gains.