The collaborative care model: realizing healthcare values and increasing responsiveness in the pharmacy workforce.

Forsyth, Paul; Radley, Andrew; Rushworth, Gordon F.; Marra, Fiona; Roberts, Susan; O'Hare, Roisin; Duggan, Catherine; Maguire, Barry

Abstract

Healthcare values are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. However, their ability to honor these values is significantly determined by the nature of the system in which they work. The paper starts by presenting the prevailing pharmacist workforce model, the 'Atomistic' Model, in Scotland, in which core roles are typically separated into hierarchically disaggregated jobs focused on one professional 'pillar': Clinician/Practice Provider; Educator; Leader/Manager; and Researcher. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating, lacking a shared purpose. Key strategic flaws include suboptimal responsiveness to population needs, inconsistency/inequity of care, erosion of professional agency and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos and organizational structure. 'Atomism' culminates in a syndrome of widespread professional-level cognitive dissonance. The paper contrasts this with an emerging workforce vision, the Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional 'pillars'. Vertical skills integration, involving education and task sharing, supports sustainability and succession planning. Horizontal skills integration (across practice, leadership/management, education and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos and career structure needed to make the model work are described. Moral and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-'pillar' professional curricula across the career spectrum. Potential challenges also are discussed.

Citation

FORSYTH, P., RADLEY, A., RUSHWORTH, G.F., MARRA, F., ROBERTS, S., O'HARE, R., DUGGAN, C. and MAGUIRE, B. 2022. The collaborative care model: realizing healthcare values and increasing responsiveness in the pharmacy workforce. Research in social and administrative pharmacy [online], 19(1), pages 110-122. Available from: https://doi.org/10.1016/j.sapharm.2022.08.016

• Journal Article Type: Article
• Acceptance Date: Aug 21, 2022
• Online Publication Date: Sep 2, 2022
• Publication Date: Jan 31, 2023
• Deposit Date: Sep 16, 2022
• Publicly Available Date: Sep 3, 2023
• Journal: Research in social and administrative pharmacy
• Print ISSN: 1551-7411
• Electronic ISSN: 1934-8150
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• Pages: 110-122
• DOI: https://doi.org/10.1016/j.sapharm.2022.08.016
• Keywords: Pharmacists; Professional values; Skill development; Values; Professionalism; Workforce
• Public URL: https://rgu-repository.worktribe.com/output/1744757
• Additional Information: In the accompanying file, the location of all figures and tables is highlighted within the main text, but the actual materials are presented together at the end of the document.