The Challenge
The Nova Scotia Pharmacy Regulator (NSPR) has long recognized the importance of pharmacies being sufficiently staffed in supporting pharmacy professionals to provide safe and effective care to the public. This requirement has been embedded in regulations since 2001. Despite this regulatory requirement, concerns brought forward by pharmacy professionals about their workplace conditions have steadily increased over the last several years.
While workplace conditions were traditionally seen as a responsibility of advocacy organizations, the NSPR became increasingly concerned about implications for quality of care and patient safety. In 2019, the NSPR set out to explore what action it could take, as the pharmacy regulator, to intervene.
The Approach
Davis Pier has been working closely with the NSPR to develop its StaffWISE Staffing Score—a robust, evidence-based, and data-driven regulatory indicator. The StaffWISE Staffing Score will enable the NSPR to ensure that Nova Scotia community pharmacies have the staffing needed to consistently deliver quality services in a way that can be sustained by pharmacy professionals.
The StaffWISE model was informed by best practice and a comprehensive understanding of the pharmacy practice environment, including the relationship between workload levels and patient safety. In addition to our in-depth preliminary research, we achieved 100% sampling of community pharmacies in Nova Scotia to gather context-specific data on staffing levels and workload, as well as a robust sampling of data related to quality and practitioner wellbeing.
We used advanced statistical modelling methods to explore the relationships between workload, staffing, wellbeing, and quality. This comprehensive, data-driven, and pragmatic approach allowed us to uncover the relationship between staffing levels, quality, and practitioner wellbeing in Nova Scotia.
The Outcome
The StaffWISE Staffing Score enables the NSPR to ensure that Nova Scotia community pharmacies have the staffing needed to consistently deliver quality services in a way that can be sustained by pharmacy professionals. The StaffWISE model and associated data collection also provide the NSPR with a broad dataset that enables evidence-informed decision-making across a variety of variables:
- dispensing volumes;
- range of clinical services provided;
- technology available to support operations; and
- nuances of geographical and operational context (e.g., the model accounts for the varied needs of a rural versus urban location, or a pharmacy within a primary care clinic or stand-alone location.)
The Impact
The findings of this project and the StaffWISE Staffing Score will be used by the NSPR to set and enforce minimum staffing levels in Nova Scotia’s community pharmacies. It is also a critical tool that will support pharmacy managers and owners in understanding and improving pharmacy operations.
The partnership between Davis Pier and NSPR has been recognized in the Canadian Pharmacists Journal as an innovative and solutions-focused approach to regulatory decision-making. This work and partnership will ensure that pharmacy professionals can continue to provide safe and effective care to Nova Scotians.