The next phase in professional services research: From implementation to sustainability

Abstract

The provision of professional pharmacy services has been heralded as the professional and the economic future of pharmacy. There are different phases involved in a service creation including service design, impact evaluation, implementation and sustainability. The two first phases have been subject to extensive research. In the last years the principles of Implementation science have been applied in pharmacy to study the initial uptake and integration of evidence-based services into routine practice. However, little attention has been paid to the sustainability of those services, during which there is a continued use of the service previously implemented to achieve and sustain long-term outcomes. The objective of this commentary is to describe the differences and common characteristics between the implementation and the sustainability phase and to propose a definition for pharmacy. A literature search was performed. Four critical elements were identified: 1. The aim of the implementation phase is to incorporate new services into practice, the sustainability phase's aim is to make the services routine to achieve and sustain long-term benefits 2. At the implementation phase planned activities are used as a process to integrate the new service, at the sustainability phase there is a continuous improvement of the service 3. The implementation phase occurs during the period of time between the adoption of a service and its integration. Some authors suggest the sustainability phase is a concomitant phase with the implementation phase and others suggest it is independent 4. There is a lack of consensus regarding the duration of each phase. The following definition of sustainability for pharmacy services is proposed: "Sustainability is a phase in the process of a professional pharmacy service, in which the service previously integrated into practice during the implementation phase is routinized and institutionalized over time to achieve and sustain the expected service outcomes". An agreement on a definition will facilitate an understanding of when the profession has reached this ultimate goal.

Community pharmacy minor ailment services: Pharmacy stakeholder perspectives on the factors affecting sustainability

“…It is also one of the first investigations that responds to a recent call to pharmacy practice research to focus on the sustainability stage of an intervention. 5 The PSAT offers a useful assessment framework that maps across the characteristics for the sustainability phase as identified through a review of current literature undertaken by Crespo-Gonzalez et al 7 In this study, the tool was particularly pertinent as a guide for qualitative data collection, as it incorporated aspects that have been recently identified as barriers to the implementation and adoption of clinical services within community pharmacy. 5 Therefore, streamlining the investigation of service routinisation and sustainability.…”

“…6 Crespo-Gonzalez et al promotes that, as services have been implemented and routinised into daily pharmacy healthcare provision, the next focus is to understand the sustainability of innovations to maintain and improve patient care over time. 7 Sustainability has been described as the process of maintaining an innovation through continued innovation use integrated as routine practice;…”

The Impact of the Psychological Contract on Academics

“…The literature also demonstrates that a global trend to construct students as clients is part of a trend toward commodification of higher education (Saunders & Blanco Ramirez, 2017). This commodification is borrowed from a professional services model that provides more than semantic description of students (Crespo-Gonzalez, Garcia-Cardenas, & Benrimoj, 2017). The empirical and theoretical critique against this conception of students is becoming widespread in the higher education literature.…”

The future of pharmacy practice research – Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA

“…An interesting approach conducted in Australia to encourage engagement of community pharmacists in research was to incentivise the system. This was achieved by incentivising the national service model, where community pharmacists were given additional funding for engaging in research (39), albeit the outcomes havent been reported yet.…”