Shannon Eaves Stratton, PharmD, BCPS, BCPP
Mental Health Clinical Pharmacy Practitioner
Richard L. Roudebush VA Medical Center
Indianapolis, IN
Dr. Shannon Stratton earned her Doctorate of Pharmacy degree from Purdue University in 2014. She completed her PGY1 pharmacy residency at Jackson Memorial Hospital in Miami, FL. She then went on to complete a PGY2 psychiatric pharmacy residency at Eskenazi Health/Purdue University College of Pharmacy. Dr. Stratton has provided medication therapy management services under collaborative practice agreements in both inpatient and outpatient psychiatric pharmacist roles. Currently, Dr. Stratton is a Mental Health Clinical Pharmacy Practitioner at the Richard L. Roudebush VA Medical Center in Indianapolis, IN.
Thinking about creating new services can be a daunting task. However, identifying something that you are passionate about and want to accomplish helps keep you motivated and challenged in your career. The following is a list of questions and answers that may be helpful to consider while starting to create a new service.
Where do I start?
Step 1: Invest time
Invest time to learn more about your practice site and the workflow of that area
In this step, focus on learning about the various healthcare provider roles and patient population at your site. This is the best time to learn the current processes in place and use this to help identify opportunities for new services. One of your goals should be to focus on adding a valuable service to the healthcare system without adding duplicity or competition to other services already offered. Furthermore, ask other healthcare providers what they have identified as areas of improvement for the practice area. As a pharmacist, we are experts in how best to integrate our skills into a variety of situations. Asking for the input of others regarding a practice area’s needs can help springboard the idea for a new service. By taking the time to focus on this step first, you can identify new services that will have the greatest impact in optimizing patient care.
I have an idea, what are the next steps?
Step 2: Research
Conducting a thorough literature search provides the framework for your idea to continue in its development. Evaluation of the literature can help in identifying if others have already created a service similar to your idea and have published their process or findings about the service. If there are little to no publications related to your idea, then this enables you to potentially have more freedom in the creation process with the possibility of conducting and publishing your service idea as research. However, this may also mean that the development stages of your new service could require more work up front. If there is available literature similar to your idea/service, you can use these resources in creating a proposal to justify the service you would like to provide. Additionally, this is a great time to reach out to listservs (ex: CPNP listserv) to see if others have attempted to set up a similar service/idea and ask for any advice, recommendations, or suggestions those individuals may have. You can then take that feedback and incorporate it into your plans.
Step 3: Ask for HELP!
It is always a good idea to have a good team in your corner. Identify other individuals that you feel may contribute and help you start your new service such as:
Gaining perspectives from others can help you avoid pitfalls that may slow down the initiation of your clinical service. It may also allow you to identify areas of growth for your service that you did not originally consider and help in getting buy-in from administration. After identifying all the individuals you feel may be able to contribute to your new service, contact them individually to find out if they are available to help. Everyone has busy schedules and a variety of other responsibilities to juggle, so it is respectful to ask them about their potential involvement prior to setting up such a meeting. For individuals who may decline due to their schedules, it is completely fair to ask if they would have time to briefly discuss any input or advice they may be able to add without being a major part of starting the service.
Step 4: Initial meeting(s)
After identifying individuals that may be able to help you in starting your new service, set up an initial meeting to further discuss your idea and what you anticipate for the service. These initial meetings are a great time to continue brainstorming and evaluating what all you would like to accomplish with the service. Starting a new service in this team-based format allows you to get a variety of perspectives and gain experience from individuals who have been working within the health system for a longer duration. Even if you will be the primary or only pharmacist responsible for this new service, I would recommend always finding a group of individuals that can help you with your idea and serve as advocates as you move through the process. A tool that you may use during this initial phase to outline the service could be a strengths, weaknesses, opportunities, and threats (SWOT) analysis. Completing a SWOT analysis or other similar analyses can help in creating a sustainable niche for your new service. These initial meetings should also be used to help identify how you will measure the success of the service. Using subjective and/or objective outcome metrics may be beneficial in justifying the impact of your service to achieve sustainability. Consider tracking objective measurements such as hemoglobin A1c or lipid values; however, subjective measurements such as quality of life or patient satisfaction are important to highlight as well. Additionally, make sure to discuss barriers that you foresee occurring and brainstorm ways you can overcome these obstacles beforehand. Funding may be a potential challenge that occurs in getting the service started. You may have to consider how the salary for a pharmacist (or other positions) will be justified by this new service. Potential funding options could be available through grants and further exploration would be required. If grants are new to you, you may consider starting at www.grants.gov.
Step 5: Meetings, meetings, and more meetings
This part of the process can potentially be frustrating; however, it is a crucial step in getting your new service started. After the initial meetings, you should have a well-developed idea of what you want your new service to encompass and how it will function. The next step is identifying the process that will need to occur to get your new service approved. Depending on what your service includes, you may have to consider presenting and gaining approval from the following example committees :
I recommend outlining this process with your group prior to committee presentations. This ensures that you are meeting with the correct individuals in the correct order and helps in the efficiency of getting your service started. For many of these presentations, you will need to assemble a proposal for your service and the content will depend on what your idea involves. It may be appropriate to complete a business plan if your idea involves adding a new position to the organization. Conversely, it may be more suitable to outline how your collaborative practice agreement will change or a process outline for how your new service will function and integrate into your current schedule. The main take away point is that you should expect to develop and present your proposal to healthcare administrators in order to justify your new service
Now what?
Step 6: Time to get started
You’ve made it! After going through the approval process and obtaining the final authorization, now it is time to start your new service. When implementing a new service, you will have to consider if there will need to be education for staff prior to starting your service. Additionally, this is a good time to finalize the metrics that you would like to track for this service. Tracking metrics will allow you to provide follow-up on the impact of your new service, guidance for overcoming any barriers not previously identified, and results to publish and contribute to current clinical literature.
Throughout the process of creating a new service there can be quite a few setbacks; however, remember what motivated you and originated the idea in the first place to help keep up your enthusiasm and drive through the process.
