Background

Thanks to practice research and quality development programmes in many countries, there is substantial evidence of the feasibility and effect of a number of defined counselling services within community pharmacy. However, practical implementation of these services is still a problem.

Project objective

To establish and test an implementation support programme that will enable Danish pharmacies to implement defined counselling services as permanent health services to the public.

Intervention

"The Counselling Pharmacy" is a "Pharmacy Care Programme" using various implementation strategies (education, quality manuals and tools, process and outcomes control, process consultant/coach, feedback/role models, training and exchange of experience). The programme runs for 1 year with the participation of eight pharmacies. The programme starts with a basic interview and a course for the pharmacy staff. Following the initial course, a coach will support the pharmacy in the implementation process making tailored use of the resources in the programme. The defined services are: 1) Basic drug information to customers; 2) Pharmaceutical care at the counter; 3) Self-medication, response to symptoms, and self-care, and; 4) Price-carrying health promotion services (examples: blood pressure measurements; smoking cessation programmes).

Evaluation

The purpose of the evaluation is 1) to describe to which degree the objectives have been reached (implementation on a permanent basis; relevant and feasible services; reasonable cost/benefit balance; continuing development of services; customers' satisfaction with the service); 2) to describe the implementation process and experience of the pharmacies and coaches, and; 3) to evaluate the relevancy of the programme and suggest improvements.

Results

A status on intermediate results has been presented in a Midway Seminar in November 2001.The process evaluation shows that the services are partly implemented, although the aim of full implementation in all eight pharmacies has not yet been achieved. The services have been modified to intensify the motivation of the pharmacy staff and their ownership of the programme. The baseline customer satisfaction showed some problems with waiting time, with customer satisfaction with the information given and access to defined extended services. The results have been used to identify areas for improvement in quality. The feedback/role model mechanism has been used to identify personal strengths/weaknesses in the dialog with the customer, to clarify the service, to identify personal "stages of change", to make personal plans for development and to evaluate the degree of implementation. The pseudo-customer evaluation was established as part of the learning process and as a control mechanism. The results have been used to improve personal performance and to evaluate the degree of implementation.

Conclusion

The services are partly implemented in the pharmacies and we still hope to reach the aim of the study. The process evaluation shows great impact on both learning, personal development and competence, organisational changes and implementation.

References

Pharmakon, Danish College of Pharmacy Practice, Milnersvej 42, DK-3400 Hilleroed, Denmark ([email protected])