Shifting boundaries

The boundaries of the pharmacy profession are shifting in Australia, which presents a fantastic opportunity.

Contemporary complex health care is driven by integration, collaboration and specialisation, and I believe pharmacy is increasingly defined by these characteristics.

Pharmacist prescribing is one such example of pharmacist specialisation realising benefits for the pharmacy profession, our medical colleagues and, most importantly, the people in our care. It is a hot topic today, but it has a much longer history in the hospital setting.

Since 2012, the frontier of pharmacist prescribing in Australia has been in the acute care setting, when the Alfred Hospital first piloted Partnered Pharmacist Medication Charting (PPMC). This collaborative model is now being embedded into practice across five states and territories and has been shown to improve patient safety and quality of care by reducing medication errors and delays to critical treatment, as well as increasing the job satisfaction not just of pharmacists, but of medical staff too.

The Victorian Government’s evaluation of PPMC across a range of regional and metropolitan hospitals found that patients who had received PPMC spent 10% less time in hospital than those who hadn’t.

One of the 12 recommendations from NSW’s ambulance ramping inquiry stated PPMC should be implemented in NSW Emergency Departments, in recognition of the benefits to safer patient care, patient flow and efficiency benefits with a constrained medical workforce.

Collaborative models allow both professions to practise at the top of their scope of practice, delivering true interdisciplinary synergy for the ultimate benefit of our patients.

This cooperation is key if we are to meaningfully address and prevent the 250,000 medication-related hospital admissions we see each year in Australia, which cost the healthcare system $1.4 billion annually.

In its review of pharmacist prescribing models, the Pharmacy Board of Australia (PBA) found no regulatory barriers in place for pharmacists to prescribe via PPMC, nor prescribing via a structured prescribing arrangement, within a collaborative healthcare environment.

Innovation around prescribing is just one in a wave of interdisciplinary advances in recent years. Hospital pharmacist-led stewardship programs in antimicrobial, anticoagulant, analgesic and antipsychotic treatments have also delivered greatly improved patient care outcomes, as well as benefits across key health system metrics.

Meanwhile SHPA has set the standard of pharmacy care in residential aged care in our Standard of practice in geriatric medicine, as a natural extension of the years of experience that SHPA and its members have in driving clinical pharmacy and medication safety in acute and subacute care.

We look forward to seeing more onsite aged care pharmacists practicing as part of multidisciplinary aged care teams in 2023.

The key to these opportunities is simple: teamwork.

True collaboration succeeds when health professionals genuinely share the same treatment and care goals across all settings, with the patient at the centre. Research consistently shows us that integrating a pharmacist into a clinical team delivers safer, more effective and more efficient results.

And success can be assured only if pharmacists with specialised skills have ready access to the education and knowledge networks while receiving recognition of their growing expertise and impact.

This is where SHPA leads the way. Through the leading Specialty Practice program, SHPA connects and uplifts pharmacists and pharmacy technicians who are committed to evidence-based practice on their professional journey, supporting them with innovative programs, tailored education and national networking, regardless of their skill level or location.

This influence and impact works two ways — across pharmacy, ensuring no individual is practising in isolation, wherever they’re based; and between professions.

By building broader understanding of complex clinical journeys — and formally recognising the underpinning skills and experience — we can work towards a future in which we are defined more by what we can do, and by the care we can provide, than by where we work.

In this way, the advances made to ensure medicines safety and optimal outcomes for patients who have acute care touchpoints, can ripple outward to benefit those who don’t.

*Tom Simpson is the President of the Society of Hospital Pharmacists of Australia. He was the 2018 Tasmanian Pharmacist of the Year and recipient of the 2019 SHPA Medal of Merit.