Tip of the Week: Develop A Framework for Sustainable Innovation in Pharmacy

The literature is teeming with examples of pharmacist services or pharmacist-led services aimed at improving health care. This is undoubtedly a great thing, but how many of these services end up being sustained for long periods of time? How many are incorporated into a broader health care and societal context? This management tip of the week presents a procedural roadmap to leverage stakeholders into developing sustained services that mean more than merely putting a feathre into pharmacy's cap.

Crespo-Gonzalez et al proffer a conceptual framework, but in doing so they first conducted a systematic review of the sustainability of innovations in pharmacy.¹ Their initial search uncovered 3123 articles, of which 132 reported on studies that met the researchers' criteria for inclusion in the qualitative systematic analysis. Many of those 132 were outside of pharmacy, but nonetheless provide perhaps even greater edification to pharmacists than those within pharmacy.

The authors found that most sustainable innovative services were under the auspices of a determinant framework, process model, or implementation/sustainability theory guidance. The most common factors impacting the services' sustainability were financial structure, organizational capacity, leadership, staff training, and adaptability.

The political environment was also important and is a factor often overlooked. This environment is described as actual and potential changes to scope of practice as well as other regulations, laws, and impacts of legislators and important community leaders, all of which can drastically impact the viability of a service. The authors used this review to offer a framework for the sustainability of professional services, found in the Figure.² At the center of the framework are the components, resources, and expected service outcomes, which are all continuously evaluated and adapted, as needed given input from the environment and in the context of the service's performance.

Performance is evaluated under 3 principle domains. First is its economic performance, which concerns its profitability but also its source(s) of funding and the financial impact of partners in the process. If a service is not benefiting these partners, then they will likely turn their support into a barrier for its continued implementation. Second is the service's environment performance. This refers to its affect on access to care and its ability to garner or repel political support and jibe with government policies and regulations. Third is the service's social performance, which considers how the service impacts employees' workload and quality of work life, skills, career development, and salary/remuneration, as well as the extent to which it is addressing patient needs and their activation to promote their own health care outcomes.

There is a wealth of information about the creation of sustainable innovations outside of pharmacy. Pharmacy managers would do well to stay atop of literature and developments, but also learn to engage others within and outside of pharmacy in order to elicit their support and also acquire ideas. Political operatives and investors, who have probably seen a wide range of successes and failures, can provide sound advice and perhaps financial backing. Implementation science is a field that can help pharmacy managers develop long-term strategies to meet the public's need for cost-effective health care challenges.

Additional information about Entrepreneurship and Innovation and Value-Added Services as a Component of Enhancing Pharmacists' Roles in Public Health can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social/behavioral pharmacy at the Touro University California College of Pharmacy.

REFERENCES

1. Crespo-Gonzalez, SI, Scerri M, Garcia-Cardenas V. Sustainability of innovations in healthcare: A systematic review and conceptual framework for professional pharmacy services. Res Social Adm Pharm. 2020; https://doi.org/10.1016/j.sapharm.20202.02.015

2. Figure. Framework for the sustainability of professional services.1 Used with permission from Elsevier, Inc.