Still Burning: An Exploration of the Impacts of the 2018/2019 Tasmanian Summer Bushfires on Community Pharmacy Operations in Affected Communities

Abstract

Introduction: Human-induced climate change is increasing the likelihood and severity of wildfires across the globe. This has negative consequences for the health of affected communities through the loss of health systems’ infrastructure and disrupted health services. Community pharmacies are a central hub between patients and the health care system and can provide continuity of care during wildfires. However, there is little in peer-reviewed literature about the impacts of wildfires on community pharmacy operations. Study Objective: The aim of this study was therefore to explore the impacts of the 2018/2019 summer bushfires in Tasmania, Australia on community pharmacy operations in affected areas. Methods: Semi-structured telephone interviews were conducted with four community pharmacists who were working in the affected region during the bushfires. Interviews were audio recorded and transcribed verbatim. Qualitative data were analyzed using two methods– manual coding utilizing NVivo software and Leximancer analysis. Inter-rater reliability was ensured by two researchers analyzing the data independently. Differences in coding were discussed and agreement reached through negotiation amongst the research team. Results: From the manual coding analysis, five key themes emerged – communication and collaboration; support; patient health challenges; pharmacist experiences in delivering health care; and future planning. These aligned with the five themes that emerged from the Leximancer analysis – community; local; town; patients; and work. Participants described working during the wildfires as difficult, with multiple challenges reported including communication difficulties, operational barriers such as power cuts, legislative barriers, logistical issues with obtaining and storing medication supplies, and lack of preparation, support, and funding. They highlighted a lack of operational and financial support from the government and received most assistance from local council bodies and local branches of professional pharmacy organizations. Conclusion: During disasters, community pharmacies help reduce the burden on public hospitals by maintaining medication supplies and treating patients with minor ailments. However, increased support and inclusion in disaster management planning is needed to continue this role.

Impact of COVID-19 on frontline pharmacists’ roles and services in Canada: The INSPIRE Survey

“…33 However, pharmacists are frequently overlooked and struggle to identify who to contact during a pandemic or a local disaster to contribute to health-related disaster decisionmaking processes. 34,35 This continual challenge was evident in our findings, with 76.3% of frontline pharmacists stating they are not engaged with the local disaster and public health groups. This indicates the need for better integration of pharmacists into disaster health teams and for the disaster health community to acknowledge the vital roles and services being undertaken by those essential primary care providers.…”

Bolstering health systems to cope with the impacts of climate change events: A review of the evidence on workforce planning, upskilling, and capacity building

“…However, only nine studies 26,28,35,37,44,64,65,69,70 in this theme discussed a training programme that had been implemented, highlighting that existing climate training and education for the health workforce is limited. Under planning for staff surge capacity, 4,5,8,10,14,27,28,30,31,[33][34][35][36]38,39,[41][42][43][44][45][46][47][48][49][50][53][54][55][56][57][59][60][61][62]67,70,72,[74][75][76] discussions centred on rostering considerations and contingency plans to ensure workforce surge capacity, as well...…”

“…Under planning for staff surge capacity, 4,5,8,10,14,27,28,30,31,[33][34][35][36]38,39,[41][42][43][44][45][46][47][48][49][50][53][54][55][56][57][59][60][61][62]67,70,72,[74][75][76] discussions centred on rostering considerations and contingency plans to ensure workforce surge capacity, as well as swift and effective mobilisation strategies to quickly increase workforce capacity. Thirty studies reported on the importance of interdisciplinary collaboration, 5,[27][28][29][30][31]33,[36][37]…”

“…Role flexibility or role substitution, in which staff took on tasks outside of their usual job description or scope of practice to cope with increased patient surges, was discussed in 16 studies. 14,28,30,31,33,36,37,39,41,44,51,53,54,59,66,74 The provision of psychological support for the workforce was another important theme, with 14 studies 4,8,9,39,41,44,48,[51][52][53][54]56,66,69 highlighting the importance of looking after workers' mental wellbeing; for example, through the provision of counselling during and after climate events or reshaping rosters to ensure staff had adequate time to rest. Twelve studies discussed additional role incentives.…”

“…Thirty-nine studies reported on the impacts of climate change on the health workforce, with four main themes identified (Table 3). The most common theme in this category was the experience of system breakdown (n = 20), 4,8,10,14,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] due to unclear allocation of staff roles and remuneration, electrical outages, and inadequate processes and preparation in healthcare facilities. This was often observed alongside unsafe conditions (n = 16) studies, 10,13,28,29,37,41-51 in which the workforce was exposed to building damages, infectious diseases, and reduced T A B L E 2 Characteristics of included studies.…”