“This is streets ahead of what we used to do”: staff perceptions of virtual clinical pharmacy services in rural and remote Australian hospitals

Abstract

Background The use of medications is the most common intervention in healthcare. However, unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in healthcare systems across the world. A Virtual Clinical Pharmacy Service (VCPS) was introduced in rural and remote New South Wales public hospitals to support safe and effective use of medications. In this model clinical pharmacy services are delivered via a telehealth cart at the patient’s bedside and through electronic medical and pharmaceutical record systems. The aim of this research was to understand healthcare staff perspectives of the VCPS and identify areas for improvement. Methods A qualitative approach informed by Appreciative Inquiry was used to investigate healthcare staff perceptions of the VCPS. Focus group discussions (n = 15) with hospital staff and medical officers were conducted via videoconference at each study site. Focus groups explored issues, benefits and barriers 3 months after service implementation. Transcribed data were analysed using thematic analysis and team discussion to synthesise themes. Results Focus group participants identified the value of the VCPS to patients, to the health service and to themselves. They also identified enhancements to increase value for each of these groups. Perceived benefits to patients included access to specialist medication advice and improved medication knowledge. Staff valued access to an additional, trusted workforce who provided back-up and guidance. Staff also reported confidence in improved patient safety and identification of medication errors. Enhanced compliance with antimicrobial stewardship and hospital accreditation standards were beneficial to the health service. Suggested improvements included extending virtual service hours and widening patient eligibility to include aged care patients. Conclusions The VCPS brought a positive, collegiate culture regarding medications. Healthcare staff perceived the VCPS was effective and an efficient way for the health service to supply pharmacy services to smaller hospitals. The ease of use, model of delivery, availability, local knowledge and responsiveness of highly skilled pharmacists was the key to user satisfaction. Trial registration ANZCTR ACTRN12619001757101, 11/12/2019.

Virtual clinical pharmacy services: A model of care to improve medication safety in rural and remote Australian health services

“…Doctors, nurses, and allied health professionals endorsed the VCPS, identified benefits, and suggested enhancements in focus groups. 10 Staff valued having an additional trusted workforce, access to specialized medication advice, improved patient safety, identification of medication errors, and enhanced compliance with antimicrobial stewardship and hospital accreditation standards. 10 Suggested enhancements included extending service hours and widening patient eligibility.…”

“… 10 Staff valued having an additional trusted workforce, access to specialized medication advice, improved patient safety, identification of medication errors, and enhanced compliance with antimicrobial stewardship and hospital accreditation standards. 10 Suggested enhancements included extending service hours and widening patient eligibility. 10 A formal analysis of this data is underway, with further results to be published separately.…”

“… 10 Suggested enhancements included extending service hours and widening patient eligibility. 10 A formal analysis of this data is underway, with further results to be published separately.…”

“…Clinicians have reported increased confidence in medication management and safety due to the support provided by pharmacists, and the service has demonstrated scalability over multiple rural and remote facilities. 10 …”

Young People and Carers’ Experience of a Rural Mobile Mental Health Support Service: A Qualitative Study

“…Virtual support services providing information, apps with meditation exercises for example, and real time access to clinicians have been growing as one way of addressing access barriers and making mental health support more accessible [13,14]. Reports of user satisfaction and outcomes of virtual care vary [15,16]. However, given the move to virtual care because of the COVID-19 pandemic it is likely virtual services will become more common as people get used to using it and clinicians become more experienced in providing it.…”