acpnews july/august 2014

newsJuly / August 2014

Healthy Albertansthrough excellencein pharmacy practice

IN THIS ISSUE...Notes From Council

2 n Brad Willsey begins term asACP President

3 n Welcome 2014-15 council

4 n Thank you to outgoingcouncillors

5 n Annual General Meetinghighlights

8 n Inducements prohibitionstayed

8 n In memory

Continuing Competence

9 n Introducing the newContinuing CompetenceProgram

Quality Pharmacy Practice

14 n “Simple” math still needschecking

Partners in Practice

15 n Scope of practice: Yours,mine, or ours?

n PEBC assessors needed

16 n Two tips for getting betterresults with less effort

At ACP, we are committed tosupporting registrants’ continuingprofessional development andexcellent pharmacy practice. One ofthe ways we do this is through ourcompetence program.

You told us that you want a flexibleprogram that is relevant to yourpractice, suits your learning style, andoffers tangible results. We listened. Wecollated your input; researchedemerging continuing competencemodels for health professionals;reviewed other college programs; and

piloted new tools, tutorials, andonline systems. The result? A new,easy-to-use, online continuingcompetence program.

The updated program focuses onquality improvement (systematic andcontinuous actions that lead tomeasurable improvement inhealthcare services), and how alearner implements newly-acquired orreinforced knowledge, skills, abilities(i.e., competencies) into practice.

Learn all about the new programstarting on page 9.

New competenceprogram for pharmacistsready to roll

It's much better than theold one, particularly

because it is focused onquality improvementand moving practiceforward rather than

quality assurance. And I like the self-assessment tools ;)

I think it's great.Far more

meaningful andimpactful topractice than

the knowledgeassessment.

Nicely presented andto the point. Liked

the option oflistening or reading

along. Good examplecases of pharmacist

implementationrecords.

Pilot participant comments

aφnews is published six times per yearby the Alberta College of Pharmacists.

Editor in chief: Greg EberhartManaging editor: Karen Mills

Please send comments or submissionsfor publication [email protected].

The deadline for submissions for theSept/Oct 2014 issue is August 7.

ACP Council ExecutivePresident: Brad Willsey President Elect: Rick HackmanExecutive Member at Large:

Taciana PereiraPast President: Kelly Olstad

Councillor email addresses are posted onour website under About ACP/Council.

Staff DirectoryRegistrar: Greg EberhartDeputy Registrar: Dale CooneyOperations and Finance Director:

Lynn PaulitschCommunications Director: Karen MillsComplaints Director: James KrempienPharmacy Practice Consultants:

Tim Fluet, Chantal Lambert, Martha Nystrom, Monty Stanowich,Jennifer Voice

Practice Development Director: Debbie LeeProfessional Practice Director: Shao LeeRegistration Manager: Linda Hagen

Staff email addresses are posted on ourwebsite under Contact Us.

Alberta College of Pharmacists1100, 8215 - 112 Street NWEdmonton AB T6G 2C8T 780-990-0321TF 1-877-227-3838F 780-990-0328

pharmacists.ab.ca

news

aφnews – July / August 2014 2

Notes fromCouncil

Brad Willsey begins term as ACP president

Biographical snapshot:n Pharmacist/Owner, Shamrock Pharmacies in Grande Prairie (2003 – present)n Pharmacy practice and healthcare consultant (2003 – present)n BScPharm from U of A, MBA from Queen’s Universityn Adjunct Professor, U of A Faculty of Pharmacy, 2003-10n 10 years hospital practice, 13 years community practicen Former Alberta Pharmaceutical Association councillor (1995-2000) and

President (1998-99)

Brad Willsey was inducted as ACPpresident on June 12, and began his termon July 1. In his acceptance speech, heintroduced his vision for qualitypharmacy care, and set a personalcontract with registrants and Albertans.

Brad emphasized that, in addition toprotecting the public, a criticalcomponent of ACP's mandate is tosupport and encourage quality care.

“Pharmacy is very good at ‘safe,’” heexplained. “We have strong systems andprocesses to ensure patient safety andcontinually improve on it. Now we mustdrive quality with the services offeredand delivered by our pharmacists andpharmacy technicians.”

How do we drive and further enhancequality care through pharmacist andpharmacy technician services? Brad

believes it is by having pharmacists andpharmacy technicians competently andconfidently working to full scope asactive participants, collaborating andpartnering with our other healthcarecolleagues. This will enhance andmaintain good and accessible healthcarefor Albertans.

Brad concluded his speech by outliningwhat registrants and Albertans canexpect from him as president.

“First, you can expect me to be a goodleader - to be open-minded, a criticalthinker, a good listener andcommunicator, and to be creative inproblem solving. You can also expectme to be a good motivator and rolemodel. My personal belief is thatleadership needs to be encouraged

continued on page 4


Welcome 2014-15 council

Brad WillseyPresidentDistrict 1

Rick HackmanPresident ElectDistrict 3

Taciana Pereira Executive Member at LargeDistrict 3

Kelly Olstad Past President District 4

Clayton BraunCouncillorDistrict 2

C. K. (Kamal) S. DullatCouncillor District 5

Brad CouldwellCouncillorDistrict 5

Kelly BoparaiCouncillor Pharmacy Technician –District A

Jennifer TeichroebCouncillor Pharmacy Technician –District B

Al EvansPublic Member

Robert KruchtenPublic Member

Mary O'Neill Public Member

Jim KehrerDean,Faculty of Pharmacy Ex officio

Bryan Hodgson Student Representative Ex officio

Photounavailable


throughout the organization and theprofessions, including all levels fromcouncil through to ACP administrationthrough to front line pharmacists andpharmacy technicians.

“Second, you can expect me to bepassionate about our professions and ourquality of care proposition, includingpractising to our full scope. Recently, Iattended the Canadian PharmacistsAssociation conference. I spoke withmany pharmacist colleagues from otherprovinces, and there is no better place topractice as a pharmacist or pharmacytechnician than Alberta. We are the envyof the country!

“Third, you can expect me to supportand encourage pharmacists to practiceautonomously to a high standard anddefend our profession against thosewho would challenge our ability to dothis. Pharmacists and pharmacytechnicians are healthcare professionalswho deliver professional healthcareservices to Albertans, regardless ofpractice environment.

“Fourth, you can expect me to continueto push the pharmacy agenda andquality pharmacy care, particularly ifhealthcare practitioners are bumping intoone another's scopes of practice, and tofind creative ways to collaborate andpartner and work to make all healthcareprofessionals better in delivering neededhealthcare services.

“Lastly, you can expect me to encourageand support pharmacists and pharmacytechnicians to be their very best and tohelp facilitate environments that allowquality care to flourish and to bring acompetitive edge to keep Alberta the bestin the country and the envy of manyjurisdictions in the world.

“This is my contract with you, all ACPmembers, and Albertans. I look forwardto fulfilling it over the next year.”

Brad Willsey

ACP President continued from page 2

Vi Becker served as a public member on ACP’s council for sixyears. Her insights and ability to pinpoint the rootof an issue made her a valued presence at thecouncil table.

Robin Burns was one of the first two pharmacy technicianobservers on council. Over the past six years, shehas been a tremendous resource and has ensuredthat the perspectives of both pharmacists andpharmacy technicians were included in councildiscussions.

Kaye Moran served on council for six years. From District 5(Calgary), she served first as councillor and thenas president for the 2012-13 council year. Kayewill continue as ACP’s appointee to thePharmacy Examining Board of Canada (PEBC).

Krystal Wynnyk brought the perspectives of both hospital andcommunity practice during her six years oncouncil. Krystal served as Vice Presidentduring her 2012-13 term.

Thank you to outgoing councillorsACP thanks outgoing council members Vi Becker, Robin Burns, Kaye Moran, andKrystal Wynnyk for their service to council.


The college held its fourteenth annual general meeting on June 11.

Registrar provides 2013-14 highlightsACP Registrar Greg Eberhart provided an overview of the college’s accomplishments over the past year.

First, he noted the progress on the five strategic goals set out by council.

Annual General Meeting highlights

ACP goals for 2013 Actions to reach goalAligns with whichstrategic objectives?

Enhance the CompetenceProgram to reflect thephilosophy, principles, andamended rules for theprogram approved by councilin 2012.

n In-depth review of program and tools, involving ACP staff,Competence Committee, registrants, and stakeholders.

n Approved Competence Program rules in December 2013.

n Competent andResponsiblePractitioners

n Credibility and TrustingRelationships

Pursue the prohibition ofinducements and loyaltyprograms provided in returnfor drugs and professionalservices.

n Published background paper, Inducements for Drugs andProfessional Services: A basis for a prohibition; research summary;and FAQ document.

n A panel of council met with multiple pharmacy stakeholders.n Council unanimously supported amendments to ACP’s Standards

and Code of Ethics for the purpose of circulating the amendmentsfor review and comment to registrants and stakeholders.

n Circulated the proposed amendments for review and comment(Nov. 27, 2013 to Jan. 31, 2014).

n Educated the public about the roles of pharmacists and pharmacytechnicians through a multi-channel public awareness campaign.


n Public and StakeholderAwareness

n Credibility and TrustingRelationships

n Effective Governanceand Strong Leadership

Increase engagement withregistrants, the public, andstakeholders through morechannels for interaction.

n Looked to registrant survey results for engagement andcommunication preferences.

n Began upgrade to ACP website to include blogs, readercomments, and a greater variety of video and audio files.

n Designed interactive online modules for jurisprudence exampreparation, our Structured Practical Training program.

n Launched Facebook and Twitter accounts.n Participated in numerous intra- and inter-professional projects and

committees.

n Accessible Caren Public and Stakeholder

Awarenessn Credibility and Trusting

Relationships

Develop a performancemanagement matrix to informdecisions necessary to carryout ACP’s strategic plan.

n Reviewed current indicators and measures.n Developing logic models and assessing performance measures for

each college program.n Developing an appropriate index for each key success factor and

for an overall Corporate Performance Index.n Developing a reporting system and cycle.


n Workplace of Choicen Credibility and Trusting

Relationships

Review ACP’s technologyneeds, explore the potentialof an online learning system,and begin identifying ourassociation managementsystem (AMS) needs.

n Completed initial phase of technology needs analysis.n Purchased Articulate Storyline online learning software. n Postponed AMS needs analysis until 2014, when we will have in-

house IT expertise.



n Workplace of Choice

continued on page 6


Registrar Eberhart explained thedistribution of funding to ACP’s threecritical success factors.

n Quality Patient Caren Effective Organizationn Public and Stakeholder Confidence

After reviewing registration statisticsand pharmacy licensing trends, theregistrar discussed the opportunitiesfor pharmacy revealed in the 2013public survey. Patients were mostsatisfied with more traditionalpharmacy services, such as providinginformation on how to takemedication, what to expect, ensuringthey get the right medication, andhelping select non-prescription items.

Patients would like to see moreevidence of their pharmacistsworking closely with the othermembers of their health team tocoordinate care. They also desiremore pharmacist follow up. Whilethese are not new roles forpharmacists, they are becoming morecritical as scopes of practice overlap,care is often fragmented, andcomplex and chronic conditionsaffect more and more people.

AGM highlights continued from page 5

25%39%

36%

25%40%

35%

2013 Projected: 2013-15

Satisfaction with pharmacistperforming roles or jobs

> 75% satisfied or somewhat satisfied

• Providing you with enough information to knowhow to properly take/use your drugs (for example,with food)

• Ensuring that you understand what results youmight expect from your drugs and when theseresults might occur

• Evaluating your prescription to ensure that youare getting the right drug, for the right reason, inthe right dose, and in the right amount

• Helping you to select and use non-prescriptionmedications such as vitamins, nutritionalsupplements, and cold remedies


51 – 75% satisfied or somewhat satisfied

• Authorizing refills on prescriptions

• Working with your health team to coordinate yourdrug therapy

• Following up with you to monitor your response todrug therapy and to provide additional support inusing your drugs properly

• Prescribing drugs for conditions that yourpharmacists are trained to care for


Roles generating lower satisfactionwere primarily newer roles. Thelower satisfaction rating stemmedfrom the fact that most patients hadnot yet experienced the services (seethe graph on page 16 of the annualreport for details).

That said, not all services that ratedlower satisfaction fell into the “new”category. Less than half (43%) of thepublic were satisfied with theirpharmacist assessing them for potentialhealth risks. As a hub of healthinformation, pharmacists are wellpositioned to promote patient wellnessand prevention, alongside treatment.

–

The presentation concluded with a reportof the very positive feedback that hasbeen coming in for the new onlinejurisprudence learning module (you canaccess it through the link in the BulletinBoard section on ACP’s homepage) andan overview of the updated competenceprogram (see article on page 9).

Annual report onACP websiteFor more details and highlightsfrom the past year, please seeACP’s 2013-2014 annual report. Itis posted on the ACP websiteunder About ACP>Annual reports.

Two resolutions were presented atthe AGM.

The resolution to re-affirm the need totransmit complete prescriptioninformation via Netcare was put forwardto help facilitate a process wherebypharmacists enter the medication name,strength, directions for use, and otherdata as required to allow identification ofcomplete prescription details in thePharmaceutical Information Network.

The sponsors of the resolutionhighlighted three reasons why takingaction is important:

1. Many pediatric patients receiveprescriptions for oral liquids that arenot commercially available andrequire a pharmacist toextemporaneously compoundingredients to fulfill the prescriptionorder, and

2. There are no uniquely assigneddesignations for these compounds,and a generic “dumby” DIN isassigned by convention whentransmitted into Netcare’sPharmaceutical InformationNetwork (PIN), and

3. These prescriptions often do notcontain drug name or strength,leading to greater potential formedication errors in a veryvulnerable patient population.

AGM participants recognized that ACPand RxA contribute to manycommittees within Netcare, and felt theresolution should reflect this, ratherthan just the Integrated ClinicalWorking Group (ICWG). Theresolution was amended accordingly,and all references to the ICWG werereplaced with Alberta Health.

The resolution to mandate that all drugsampling be done via drug samplecards dispensed from licensedpharmacies generated questions aboutdrug sampling in general.

n Why should sample card practicecontinue when pharmacists may nowoffer trial prescriptions?

n How do we ensure that drugsampling information is recorded onNetcare?

n How do we capture complete druginformation when sampling occurs?


50% or less satisfied or somewhat satisfied

• Assessing your potential health risks

• Administering immunizations (such as flu shots orvaccine boosters)

• Writing care plans for your continued health caretreatment

• Discussing lab results important to your treatmentwith you

• Administering other drugs by injection

AGM resolutions carried

continued on page 8


After considering these questions, theresolution was amended to request thatACP work with CPSA to discuss thewhole practice of drug sampling.

Registrants participating in the AGM,both in person and online, were invitedto vote on the amended resolutions viaelectronic ballot on June 16 and 17. Bothof the amended resolutions were passed.Council will consider them at its nextmeeting in October.

Will ACP continue tohold annual generalmeetings?The college provided registrants theability to participate in person or via webbroadcast. Apart from ACP councillorsand staff, only 29 voting membersattended – 15 in person and 14 online.

Given these numbers, coupled with thesteady decline in AGM attendance overthe past years, council will evaluate thevalue of holding annual general meetingsand will explore other options forengaging with registrants.

AGM highlights continued from page 7

�

�In memory...� William Dickey died on June20, 2014 at the age of 93. Heenjoyed a long and rewardingcareer in pharmacy in Calgary. Hewas known as the travellingdruggist in Alberta as he enjoyedmany years of doing relief workthroughout the province.

� Erika Klein died on May 17,2014 at the age of 69. Erika wasimmigrated to Barrhead fromGermany in 1949. She obtained herBScPharm in 1968 and began hercareer in Edmonton. The lure of herhigh school sweetheart andchildhood home was strong and in1988 Erika organized and openedthe pharmacy department for theBarrhead Co-op. She worked thereuntil her retirement in 2005.

� Robert (Bob) Roberge died onJune 17, 2014, at the age of 87years. Bob graduated from U of Swith a Bachelor of Pharmacy in1951. He and his family moved toCalgary in 1963 where he openedStadium Pharmacy; a store he andhis wife, Mary, ran with vision,passion and dedication until theirretirement in 1988.

Inducements prohibition stayedSobeys, operating as Safeway and Sobeysin Alberta, applied to the Court ofQueen’s Bench for a judicial review of theprohibition on inducements. The judicialreview is scheduled to be heard by theCourt in January 2015.

The prohibition on inducements was tocome into effect on June 10, 2014. Sobeysapplied to the Court for a stay on theprohibition on inducements until thejudicial review can be heard by theCourt. The application for the stay washeard on May 23, 2014. On June 4, 2014,the judge made his ruling and grantedthe stay until Sobeys’ application forjudicial review can be heard.

Therefore, in accordance with thedirection of the court, the amendmentsprohibiting inducements on the conditionthat a patient obtain a drug product orprofessional service did not go into effecton June 10. Those amendments arestayed until the Court hears argumentsabout and decides Sobeys’ application forjudicial review.

When amending our standards and codeof ethics, our council made a carefullyconsidered decision acting within itsauthority and responsibilities. At thejudicial review, the college will defendthe amendments that prohibitinducements conditional on a patientobtaining a drug product or professionalservice from a regulated member orlicensed pharmacy.


What has not changed?n All pharmacists on the clinical register must complete a minimum

of 15 continuing education units (CEUs) in each CE cycle (June 1to May 31).

n CEUs may be earned through either accredited or non-accreditedlearning activities.

n To facilitate more meaningful reflection, a maximum of eightCEUs of non-accredited learning may be recorded on one learningrecord. For accredited learning, all CEUs assigned by theaccreditor can be claimed on the same learning record.

n Pharmacists who have successfully completed the RxCELcompetence program audit or who have received additionalprescribing authorization will be exempt from random selectionfor audit for five years from the date of completion.

What is new?n Random selection for competence assessment has been removed;

all clinical pharmacists must submit a professional portfolio eachCE cycle.

n The Knowledge Assessment (KA) exam has been removed fromthe program.

n A self-assessment module has been created to help you identifyyour learning needs.

n Upon completion of the program, all participants will havedeveloped a Professional Portfolio consisting of Learning Record(s)that document learning activities of at least 15 continuingeducation units, one Implementation Record that documents theimplementation of at least one of these continuing educationunits, and supporting documentation for both the LearningRecord(s) and Implementation Record.�

Introducing the new Continuing Competence Program

Continuing Competence

ACP’s new Continuing Competence Program (CCP) is designed to help you, as a clinical pharmacist, developprofessionally, track your growth over time, and build a portfolio that showcases your skills, knowledge, and abilities.No matter if you are new to practice or a veteran, no matter where you practice, and no matter what your practiceinterests and areas for growth, you can tailor the new program to suit your needs.


How does the program work?Pharmacists can access all program materials through the CCP webportal on the ACP website. You will fill out all forms, uploaddocuments, and compile a portfolio of your learning in your own secureonline repository.

The CCP requires the following four things of all pharmacists on theclinical register in each CE cycle (June 1 to May 31):

1. You must complete at least 15 CEUs during each CE cycle.

CEUs can be earned from either accredited or non-accreditedlearning activities.

2. You must record all learning on one or more Learning Records. See Figure 1 on page 13.

The Learning Record is an online form on the CPP web portal. Itmust be completed for all accredited and non-accredited learning. Onthe Learning Record, you will record:

n The title of the learning activity,

n The date it was completed,

n The number of CEUs that you are claiming,

n The type of learning activity (group program, workshop, self-study, etc.),

n The NAPRA competency categories that the learning relates to,

n Whether you acquired new knowledge of skills or confirmed thatyour knowledge or skills are current,

n The key elements that you learned, and

n The impact that the learning will have on your practice.

You will be required to either upload a certificate or document oflearning or, if no certificate is available, you will be required todescribe the learning activity and explain how it relates to thecompetency category chosen. Although this seems like a lot ofdocumentation, many of the categories consist of checkboxes ordrop-down lists. We expect it will typically take only five to tenminutes to complete the learning record.

3. You must implement at least one CEU of learning into yourpractice and document this on an Implementation Record.

The Implementation Record documents which learning you haveimplemented into your practice, why you chose to implement it, andwhat your objective was for implementing this learning.

4. You must complete any required learning that has been assigned bythe Competence Committee.

The CCP program rules allow the competence committee to identifyrequired learning that must be completed by all pharmacists. For the2014/15 CE cycle the required learning is a web based tutorialdescribing the revised CCP program and explaining how to recordyour learning and implementation on the CCP web portal. Thistutorial and access to the CCP web portal will be available in July.Watch for an announcement in The Link.

Why does ACP need a competenceprogram? Patients have a right to assume that a healthcareprofessional’s practice permit is assurance ofcurrent professional competence. Healthcarecolleagues want assurance that those with whomthey practice are current and competent. Forthese reasons, the Health Professions Act (HPA)requires that council establish a continuingcompetence program.

What about pharmacy technicians?Work will begin on the creation of a parallelcompetence program for pharmacy techniciansin the last half of 2014. The Health Professions Actrequires that a competence program be in placewithin 5 years of a profession coming under theact. Pharmacy technicians came under the HPAin 2011 therefore a competence program is notrequired until 2016.

New Continuing Competence Program


CCP PhilosophyACP fosters professional growththat inspires and empowerspharmacists and pharmacytechnicians to continuouslyenhance their practices andsupport Albertans’ health andwell-being. With a shared visionof excellent pharmacy practice,ACP and its registrants worktogether to identify competencegoals and milestones signifyingsuccess, and ensure that learningtransfers into practice.

CCP Guiding PrinciplesThe revised competence programwill incorporate five guidingprinciples to enable pharmacists toidentify and approach learningopportunities relevant to theirpractice setting.

n Flexible: different practicesettings and learningpreferences; addresses fullspectrum of learning

n Engaging: inspires career longlearning, peer to peerinteraction and opportunity toconnect with mentors, thoughtleaders and SMEs

n Forward-looking: help meetchanging needs of Albertans,integrates with other ACPprograms, support throughoutcareers

n Sustainable: anticipatesgrowing and diversepopulations, evidence informedtools that can be applied to adiversity of practices

n Responsible: meets legislativerequirements, providesreliable measures that allowassurance that professionalsare competent to provide safeand effective care

Figure 1 – Learning Record

Figure 2 – Program overview


Program categories and componentsThe Continuing Competence Program consists of four categories, or stages.

Category 1 requires you to:

n Complete at least 15 CEUs,

n Record that learning on Learning Records,

n Implement at least one CEU of learning into your practice and document this on an Implementation Record,

n Complete any required learning that has been assigned by the Competence Committee, and

n Submit a portfolio at the end of each CE cycle.

A portfolio consists of your Learning Records and an Implementation Record. You must submit these records to ACP via theCCP web portal in order to renew your practice permit.

ACP will select a percentage of portfolios to be audited by trained pharmacist assessors. You may be selected for auditthrough random selection, or based on late or incomplete portfolio submission, or upon request of the registrar who hasidentified an issue arising from a request for registration, issuance of a practice permit, renewal of a practice permit, or theresults of a practice visit.

The peer assessment is a criterion-based assessment (i.e., based on established criteria). This means the assessment will be asobjective and fair as possible. Following the assessment of portfolios, pharmacists will be notified if their portfolio wasassessed. (You will have already submitted all your documents with your portfolio, so will not need advance notice as wasthe case with audits in the previous program.)

There are three possible outcomes to the assessment.

Category 1

If you meet the establishedstandard, you will benotified that you have beenaudited and that the auditwas satisfactory. You may ormay not be provided withfeedback to improve yourportfolio. You will be directed tocontinue the program on anannual basis and you willnot be subject to randomaudit for the next five years.

Outcome 1

If you did not meet theestablished standard and yourportfolio has significant gaps,errors, or omissions, or if theaudit at the close of yourCategory 2 CE cycle finds yourportfolio does not meet theestablished standard, yourcase will be referred to theCompetence Committee todetermine whether you will berequired to complete theprogram in the following CE cycle in Category 3 orCategory 4.

Outcome 3

If you did not meet theestablished standard but yourdeficiency was minor innature, you will be notifiedthat your portfolio wasaudited and that it was notsatisfactory. You will beprovided with feedback onhow to improve yourportfolio. You will be placedin Category 2 of the program.

Outcome 2

New Continuing Competence Program


Maintaining competence is a professionalresponsibility and the hallmark of self-regulated professionals. In this context,maintenance doesn’t mean staying thesame, it means keeping up with (or ahead of)the changes around you.

According to your Code of Ethics, it isyour professional responsibility to:

n Continuously improve your level ofprofessional knowledge and skill,

n Take responsibility for maintaininga high standard of professionalcompetence,

n Evaluate your individual practiceand assume responsibility forimprovement, and

n Keep informed about newpharmaceutical knowledge.

ACP has created the CCP to help youmeet these responsibilities. Byidentifying appropriate learningactivities and implementing thatlearning into practice, you cancontinually build your competence andconfidence to assure yourself, yourpatients, and your healthcarecolleagues that you are providingquality care throughout your career.

Category 2 of the programmeans that you complete anew portfolio in the followingCE cycle, using the feedbackprovided to you. Thatportfolio will be audited atthe end of the CE cycle.

A clinical pharmacist inCategory 3 must meet therequirements of theContinuing CompetenceProgram and any additionalactivities directed by theCompetence Committee, andwill be subject to audit at theend of the CE cycle.

Category 3

A clinical pharmacist inCategory 4 must undergo acompetence assessment asdirected by the CompetenceCommittee within thetimelines they prescribe.

Category 4

Self-assessment In addition to the LearningRecords and the ImplementationRecords sections of the CCP webportal, there is a self–assessmentsection. Completion of the self-assessment is optional, but weencourage you to use the toolsthere to understand your currentwork environment, developeducation action plans, clinicalpractice area plans, and test yourknowledge of ethics andjurisprudence. Completing theseactivities will help you identifylearning and implementationactivities that are appropriate toyour practice.

We can add other self-assessment activities to theprogram in the future. Please provide feedback via theportal if you would like to seenew or different tools included.

Category 2

This is your program

If the audit of a pharmacist at Category 1, 2 or 3 is successful, the pharmacist will not berandomly selected for audit for the next five years.


The college has recently investigatedseveral complaints stemming frommedication errors made whenregistrants performed a calculation aspart of prescription preparation. In onecase, a patient was twice dispensedprescriptions for Cytomel that wereincorrectly calculated by pharmacistsand that resulted in the patientingesting ten times the prescribed dose.

Follow these tips for ensuring accuratecalculations.

n Ensure calculations, especiallyunusual calculations, areconsistently documented on theprescription or transaction recordand checked by two members of thepharmacy team. If a pharmacist isworking independently, have asecond pharmacy staff membercheck the calculations at the earliestopportunity (such as the beginningof the next shift).

n As part of the prescription processingand assessment process, always circle(or otherwise clearly document)medication strengths on writtenprescriptions that contain a change ina patient’s previous dose.

n Be extra diligent in processing anddispensing “high-alert” drugs, such asprednisone, methotrexate, andwarfarin. Not only can high-alertdrugs cause significant harm topatients when used in error, but thesedrugs often require dosingcalculations as part of the dispensingprocess. Pharmacists and pharmacytechnicians should regularly reviewcurrent high-alert drug listings fromsources such as the Institute for SafeMedication Practices (seewww.ismp.org/communityRx/tools/ambulatoryhighalert.asp).

n Implement a warning system forstocked high-alert drugs within thepharmacy and audit theimplementation of the warningsystem quarterly.

n When performing the final check on aprescription, including any requiredcalculations, always check the originalwritten prescription first, beforereviewing the prepared prescriptionbottle or transaction record.

• This checking includes neverapplying a signature to aprescription transaction record

until the pharmacist or pharmacytechnician has verified theprepared prescription is 100%current, complete, accurate, andappropriate.

n Ensure that once a critical task hasbeen started (e.g., making/verifying acalculation as part of a final check ona prescription), it is completedwithout interruption, or if aninterruption cannot be avoided,ensure the critical task is repeatedfrom the beginning.

n Specify the length of therapy orderedby the prescriber within the writteninstructions on the prescription label.

n Specify both the volume and quantityfor the calculated dose of all liquidmedications within the writteninstructions on the prescription label,(e.g., Take 5ml (125mg) three timesdaily for ten days).

n Review and implement the ACP’sChat, Check and Chart (CCC) tools toassist in patient assessment, as anadditional means of verifying theappropriateness of prescriptioncalculations. By more consistentlyasking the three prime questions,pharmacists and pharmacytechnicians can better verify theaccuracy of any prescriptioncalculations they are required to make.

• Look to the January 21, 2014edition of The Link for CCCresources. All editions of The Linkare archived on the ACP website.

n When dealing with a patient’s agent,confirm that the agent is aware of howthe patient has been instructed to takethe medication and can relate allinformation provided by thepharmacist back to the patient, suchas confirming number of dosage units(such as tablets or capsules) to betaken and duration of therapy. If thepatient’s agent cannot confirm orrelate the necessary inform, contactthe patient directly.

Notesfrom the field

“Simple” math still needs checking

QualityPharmacyPractice


A Tri-Profession Symposium review fromACP Past President Kelly Olstad

A doctor, a nurse, and a pharmacist walkinto a room…

It may sound like the start of a joke, but,in fact, it was the start of the recent (May22-23) Tri-Profession Symposiumdesigned to help the three professionswork together more effectively in the faceof changing scopes of practice and achanging health system.

In past years, a tri-profession conferenceopen to all members was held. Thisyear, a symposium brought togetherboard and administrative leaders fromACP, the Alberta Pharmacists’Association, the Alberta MedicalAssociation, the College and Associationof Registered Nurses of Alberta, and theCollege of Physicians & Surgeons ofAlberta for a more focused discussion.

During the symposium, we discussedboth examples of health teams workingwell and examples where there werechallenges with working effectivelytogether. Many of the challenges were adirect result of communication failuresand misunderstandings betweenhealthcare professionals, particularlywhere scopes of practice overlapped.

Where scopes overlap, clarify roles andresponsibilities at the outset. Whenmultiple professionals are providing care,ensure everyone is clear about who willbe providing follow up. In all cases, it is

critical to communicate clearly and checkfor understanding with both patients andyour healthcare colleagues. Clearcommunication can help:

n Mitigate confusion,

n Prevent duplication of services,

n Save time, and

n Ultimately lead to better patient care.

At the conclusion of the conference, thethree professions agreed that we willcontinue to explore opportunities formore regular collaboration at board andorganizational levels to create greaterunderstanding about each others’challenges and perspectives. Thisunderstanding can filter down to helpcreate and foster more collaborativeworking relationships at the front lines.We also expressed a strong desire to

continue to act and speak together whenworking with government to identify,understand, and solve problems in thehealth care system.

Resources

Looking for help with communication?Check out these resources on the ACPwebsite:

n Transition Times, Oct 2008 – TheCommunication Issue

n Understanding your pharmacist’s rolein renewing or adapting yourprescription brochure – available fordownload or as hard copies at nocost from the college office ([email protected] copies).

Partnersin Practice

Scope of practice: Yours, mine, or ours?

Where scopes overlap, clarify roles and responsibilities at the outset.When multiple professionals are providing care, ensure everyone isclear about who will be providing follow up. In all cases, it is criticalto communicate clearly and check for understanding with bothpatients and your healthcare colleagues.

PEBC assessors needed PEBC invites interested pharmacists and pharmacy technicians to apply asassessors. Exams are held in both Calgary and Edmonton on the following dates:

n OSPE (pharmacy technician exam) – Sunday, September 7n OSCE (pharmacist exam) – Saturday, November 8

The PEBC Assessor Application Form provides further eligibility and applicationdetails. You can find the form on the ACP website under Practiceresources>Forms>Other.

Canadian Publication Agreement Number: 40008642

Return undeliverable Canadian addresses to:Alberta College of Pharmacists1100 - 8215 112 Street NW, Edmonton, AB T6G 2C8news


ACP emails and newsletters are official methods of notification to pharmacists andpharmacy technicians licensed by the college. In addition to providing you with timelyinformation that could affect your practice, college emails serve in administrativehearings as proof of notification. Make sure you get the information you need topractice legally and safely by reading college newsletters and ensuring ACP emails arenot blocked by your system.!

As pharmacists continue to expandtheir scope of practice, opportunitiesto become more involved in patientcare are increasingly common. Thebiggest challenge for many isfinding ways to add these activitiesto their practice without impactingother aspects of patient care.Fortunately, there are a number ofsmall things that pharmacists can dothat yield big results – these arewhat are known as vital behaviours.With 20% of the effort, vitalbehaviours will give you 80% of theresults, meaning that you can domore with without having todrastically increase your workload.

So what do vital behaviours look likefor pharmacists?

Connect with the patient atthe start of the interaction

Take a moment to listen to patients,identify their needs, and set theirexpectations. This creates anenvironment where patients areprepared to participate in their care.

Confirm and document theindication, whether it is a new prescription or a refill

It can be as simple as saying, “Thereare many uses for this medication; canyou tell me what you are using thisfor?” This lets the patient know thatyou are interested in being involvedwith their care, and will get youvaluable information to help managetheir medications.

Don’t stop at asking, “Have you had thismedication before?” and makeassumptions. Keep going with yourChat, using the 3 Prime Questions.

An example of successACP Professional Practice ConsultantMonty Stanowich shared a story ofwhat this looks like in practice: “Thepharmacist was inconsistent and notroutinely gathering indication. Wediscussed the importance of this to theassessment process and, at her request,I provided her with a stamp [todocument patient assessment]. When Ireturned, she had not only adopted the

stamp for antibiotics, as we hadplanned, but was using it foreverything and consistentlydocumenting indication for all newscripts. She has a scanner and all scriptsare scanned after documentationoccurs. She expressed that once shestarted using the stamp and it becamepart of her process she saw how easy itwas and it felt natural to do it all thetime. She found people were verywilling to talk about it [the indication]and it really helped build rapport.”

Two tips for getting better results with less effort

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Example of stamp used

acpnews july/august 2014

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