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The Imperative for Practice Model Change

Dec 26, 2010
Henri R. Manasse, Jr., Ph.D., Sc.D.

Henri R. Manasse, Jr., Ph.D., Sc.D.

It is my profound privilege to speak to such an esteemed gathering of leaders of health-system pharmacy practice. We have a big job facing us in the months and years ahead: to conceptualize and reconfigure pharmacy practice from how it is currently constructed in hospitals and health systems, including its ambulatory component.

This summit is a culmination of a concerted effort at ASHP to renovate our profession. In February 2009, ASHP and the ASHP Foundation brought a group of leaders to headquarters to help define and shape a vision for practice model change. We had no money, no affirmed game plan, and no practitioner champions.

With the advice of these members and supported by the hard work of staff, we have started the work of creating a brand, raised tens of thousands of dollars in support, placed ASHP leaders on at least 30 podiums at a variety of ASHP and other pharmacy meetings, including international discussions, to present this vision and Initiative, and kicked off the Pharmacy Practice Model Initiative with a world-class summit.

Overall, pharmacy has made some progress in implementing clinical pharmacy and pharmaceutical care, most substantially in hospitals and health systems. But I am confident that everyone here would readily acknowledge that much more needs to be done to fully realize the development of clinical pharmacy practice and the application of pharmaceutical care. We must now ask ourselves whether we are content with the slope of the innovation curve, which is now approaching 40 years.

Redefining care models will not happen if we continue to simply do more of what we have been doing and deploy our scarce resources in the same way. Current resources, including our human resources, simply are not configured and deployed in a way to achieve the progress that is needed.

I believe that this is the time to be bold and dynamic in our thinking. We need to move past what we know, into a realm of what is possible and to construct a vision for a desired future.

The PPMI is about rethinking, redefining, reconstructing, and reinventing. Our goal is to generate passion, commitment, and action among hospital and health-system pharmacy leaders and practitioners to significantly advance the health and well-being of patients by optimizing the role of pharmacists in providing direct patient care.

Although the conceptualization of new practice models can be achieved fairly rapidly, the actual renovation of practice will take time. So, in order for us to get to the end goal of better, safer patient care, we need to be steadfast in our determination and conviction that it can be achieved. Moreover, we must tap our own covenantal ethical and moral imperative to care for patients as sustenance on this path to change. And each of us must take ownership in leading and implementing the necessary changes.

As author Gordon Goldstein has reminded us, “conviction without rigor is a strategy for disaster.”1 We not only have to act, but we must do the right things for the right reasons. We must be rigorous in our leadership on behalf of patients, and we must stay that course over time, even when opposed and when tempted to compromise.

1. Goldstein, GM. Lessons in Disaster: McGeorge Bundy and the Path to War in Vietnam. Times Books/Henry Holt & Company; 2008.

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