Mindset modification of community pharmacists in a collaborative relationship between a major hospital and neighboring community pharmacies: a qualitative study

大型医院与邻近社区药房合作关系中社区药剂师思维模式的转变:一项定性研究

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Abstract

BACKGROUND: Patient information sharing between hospitals and community pharmacies is generally insufficient. Since August 2013, the pharmacy department of Kyoto University Hospital has initiated and mediated a collaborative relationship between physicians and neighboring community pharmacies (e.g., sharing outpatient blood test results, holding regular meetings among professionals, delivery of tracing reports from community pharmacists to physicians about outpatients). METHODS: This study describes how community pharmacists have developed as a result of this professional collaboration (known as the "Kyoto University Hospital model") and attempts to grasp its current situation through interviews with pharmacists. The authors conducted semi-structured individual interviews with community pharmacists between June and December 2014. The interview data were analyzed using the constant comparative method. RESULTS: Twenty-one pharmacists working for 11 neighboring community pharmacies were interviewed, at which point theoretical saturation was achieved. The mean interview time was about 50 min. Among the participants, there were 15 women and 6 men; 10 were pharmacist managers and 11 were staff pharmacists. Through the analysis of the interview data, 13 categories were generated from 32 concepts. The results indicated that, through the Kyoto University Hospital model, community pharmacists shifted from a "Mindset of being the hospital's subcontractor" to "Being motivated to participate in team care." Specifically, their professional attitude shifted in a positive direction to "Being motivated to participate in team care", which was a departure from their previous feelings of inadequacy, related to their "Mindset of being the hospital's subcontractor" and how "Barrier to medicine counseling". CONCLUSIONS: Under the Kyoto University Hospital Model, hospital pharmacists encouraged active collaboration between physicians, hospital pharmacies, and community pharmacists by cultivating face-to-face relationships. This in turn helped community pharmacists become more conscious of their expert status, and thereby participate actively in patients' treatment.

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