Facilitation influence on community pharmacy practice transformation in the Flip the Pharmacy program.

Abstract

Background: The Flip the Pharmacy (FtP) program utilized hands-on facilitation to help CPESN®-participating community pharmacies transform their practices. There are limited data on the characteristics of successful facilitation as well as the factors that influence transformation. The objectives of this research were to: (1) evaluate practice transformation in a sample of FtP program participating pharmacies, (2) analyze the association between facilitation activities and practice transformation components, and (3) identify factors for successful facilitation.

Methods: A cross-sectional mixed-mode survey was administered to FtP program Cohorts 1 and 2 participating pharmacies (n=809). The survey consisted of five main sections: (1) practice transformation using five work components of the Systems Engineering Initiative for Patient Safety (SEIPS) model; (2) questions on the facilitator's strategy, activities, and tools (3) overall practice transformation (4) demographics (5) pharmacy characteristics. Data analysis included descriptive statistics and linear regressions on: (1) perceived overall practice transformation regressed on facilitation strategy, tools, and activities, and (2) within SEIPS components, practice transformation regressed on its correspondent facilitation activity.

Results: Perceived overall practice transformation was positively associated with coaching facilitation strategy (β =0.365, p<0.01), facilitation tools (β =0.37, p<0.01), and staffing (β =0.193, p<0.01). Cohort 1 had a higher perceived overall practice transformation vs. cohort 2. The facilitator's activities and facilitation tools were significant predictors for practice transformation in different work system components: Building capacity activity, Human Resources facilitation activity, Workflow design facilitation activity, Workspace facilitation activity, and IT use facilitation activity, with a standardized betas of (β =0.33, 0.25, 0.32, 0.31 ,0.22, P<0.01 ) respectively.

Conclusion: The facilitator's coaching strategy and activities positively impacted practice transformation. It was also found that facilitation tools are key components to better engage pharmacists in practice transformation. Finally, the utilization of SEIPS work system components presented a holistic evaluation tool of practice transformation.