Advertisement

Pharmacy World & Science

, Volume 32, Issue 2, pp 130–138 | Cite as

Flexibility in community pharmacy: a qualitative study of business models and cognitive services

  • Eleonora Feletto
  • Laura K. Wilson
  • Alison S. Roberts
  • Shalom I. Benrimoj
Research Article
First Online:

Abstract

Objective To identify the capacity of current pharmacy business models, and the dimensions of organisational flexibility within them, to integrate products and services as well as the perceptions of viability of these models. Methods Fifty-seven semi-structured interviews were conducted with community pharmacy owners or managers and support staff in 30 pharmacies across Australia. A framework of organisational flexibility was used to analyse their capacity to integrate services and perceptions of viability. Data were analysed using the method of constant comparison by two independent researchers. Results The study found that Australian community pharmacies have used the four types of flexibility to build capacity in distinct ways and react to changes in the local environment. This capacity building was manifested in four emerging business models which integrate services to varying degrees: classic community pharmacy, retail destination pharmacy, health care solution pharmacy and networked pharmacy. The perception of viability is less focused on dispensing medications and more focused on differentiating pharmacies through either a retail or services focus. Strategic flexibility appeared to offer pharmacies the ability to integrate and sustainably deliver services more successfully than other types, as exhibited by health care solution and networked pharmacies. Conclusion Active support and encouragement to transition from being dependent on dispensing to implementing services is needed. The study showed that pharmacies where services were implemented and showed success are those strategically differentiating their businesses to become focused health care providers. This holistic approach should inevitably influence the sustainability of services.

Keywords

Australia Business models Community pharmacy Cognitive pharmaceutical services Implementation Pharmacy organisation 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgement

The researchers wish to thank the community pharmacies across Australia for participating in the study.

Funding

This research project is funded by the Australian Government Department of Health and Ageing as part of the Fourth Community Pharmacy Agreement through the Fourth Community Pharmacy Agreement Grants Program managed by the Pharmacy Guild of Australia.

Conflicts of interest statement

There are no conflicts of interest to declare by the authors.

References

  1. 1.
    Cipolle R, Strand L, Morley P. Pharmaceutical care practice. New York: McGraw-Hill Medical; 2004. ISBN 0071362592.Google Scholar
  2. 2.
    Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43.PubMedGoogle Scholar
  3. 3.
    Roberts AS, Benrimoj SI, Chen TF, Williams KA, Aslani P. Practice change in community pharmacy: quantification of facilitators. Ann Pharmacother. 2008;42(6):861–8. doi: 10.1345/aph.1K617.CrossRefPubMedGoogle Scholar
  4. 4.
    Bond CM. Evolution and change in community pharmacy. London: Royal Pharmaceutical Society of Great Britain; 2003. http://www.rpsgb.org.uk/pdfs/chevcommphsyn.pdf. Accessed 22 March 2009. ISBN 0-9538505-9-5.
  5. 5.
    Roberts AS, Benrimoj SI, Dunphy DC, Palmer IC. Community pharmacy: strategic change management. Sydney: McGraw-Hill Medical; 2007. ISBN 0074717782.Google Scholar
  6. 6.
    Tsuyuki RT, Schindel TJ. Leading change in pharmacy practice: fully engaging pharmacists in patient-orientated healthcare. Alberta: COMPRIS, University of Alberta; 2004.Google Scholar
  7. 7.
    Chen TF. Pharmacy workforce planning study: literature review. Canberra: Australian Government Department of Health and Ageing; 2008. http://www.guild.org.au/research/4cpa_project_display.asp?id=1852. Accessed 17 May 2009.
  8. 8.
    Gadiel D. Harmacy: the political economy of community pharmacy in Australia. St Leonards: The Centre for Independent Studies; 2008. http://www.cis.org.au/policy_monographs/pm89.pdf. ISBN 9781864322132.
  9. 9.
    Benrimoj SI, Frommer MS. Community pharmacy in Australia. Aust Health Rev. 2004;28(2):238–46.CrossRefPubMedGoogle Scholar
  10. 10.
    Hopp TR, Klinke BO, Sorensen EW, Herborg H, Roberts AS. Implementation of cognitive pharmaceutical services in Danish community pharmacies—perceptions of strategists and practitioners. Int J Pharm Pract. 2006;14(1):37–49. doi: 10.1211/ijpp.14.1.0006.CrossRefGoogle Scholar
  11. 11.
    Venkataraman K, Madhavan S, Bone P. Barriers and facilitators to pharmaceutical care in rural community practice. J Soc Admin Pharm. 1997;14(4):208–19.Google Scholar
  12. 12.
    Gastelurrutia MA, Benrimoj SI, Castrillon CC, de Amezua MJC, Fernandez-Llimos F, Faus MJ. Facilitators for practice change in Spanish community pharmacy. Pharm World Sci. 2009;31(1):32–9. doi: 10.1007/s11096-008-9261-0.CrossRefPubMedGoogle Scholar
  13. 13.
    Roberts AS, Benrimoj SI, Chen TF, Williams KA, Aslani P. Implementing cognitive services in community pharmacy: a review of facilitators used in practice change. Int J Pharm Pract. 2006;14:163–70. doi: 10.1211/ijpp.14.3.0002.CrossRefGoogle Scholar
  14. 14.
    Berbatis CG, Sunderland VB, Joyce A, Bulsara M, Mills C. Enhanced pharmacy services, barriers and facilitators in Australia’s community pharmacies: Australia’s National Database Project. Int J Pharm Pract. 2007;15(3):185–91. doi: 10.1211/ijpp.15.3.0005.CrossRefGoogle Scholar
  15. 15.
    van Mil JWF, Schulz M, Tromp TFJD. Pharmaceutical care, European developments in concepts, implementation, teaching, and research: a review. Pharm World Sci. 2004;26(6):303–11. doi: 10.1007/s11096-004-2849-0.CrossRefPubMedGoogle Scholar
  16. 16.
    Rovers JP, Currie JD, Hagel HP, McDonough RP, Sobotka JL. A practical guide to pharmaceutical care. 2nd ed. APHA Publications; 2003. ISBN 1582120498.Google Scholar
  17. 17.
    Mobach MP, van der Werf J, Tromp TDF. APOM-project: an investigation of pharmacy organization and management. Pharm World Sci. 1996;18(2):83–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Munroe WP, Rosenthal TG. Implementing pharmaceutical care: evolution vs. revolution. Am Pharm. 1994;NS34(4):57–67.PubMedGoogle Scholar
  19. 19.
    Hagel H, Rovers J. Managing the patient-centered pharmacy. Washington, DC: American Pharmaceutical Association; 2002. ISBN 978-1582120102.Google Scholar
  20. 20.
    Desselle SP, Zgarrick DP. Pharmacy management: essentials for all practice settings. New York: McGraw Hill; 2004. ISBN 978-0071418690.Google Scholar
  21. 21.
    Clark B, Mount J. Pharmacy service orientation: a measure of organizational culture in pharmacy practice sites. Res Social Admin Pharm. 2006;2(1):110–28. doi: 10.1016/j.sapharm.2005.12.003.CrossRefGoogle Scholar
  22. 22.
    Roberts AS, Hopp T, Sørensen EW, Benrimoj SI, Chen TF, Herborg H, et al. Understanding practice change in community pharmacy: a qualitative research instrument based on organisational theory. Pharm World Sci. 2003;25(5):227–34.CrossRefPubMedGoogle Scholar
  23. 23.
    White R. Unlocking innovation in community pharmacy. PhD Thesis, Southern Cross University; 2003.Google Scholar
  24. 24.
    Noyce PR. Providing patient care through community pharmacies in the UK: policy, practice, and research. Ann Pharmacother. 2007;41(5):861–8. doi: 10.1345/aph.1K015.CrossRefPubMedGoogle Scholar
  25. 25.
    Feletto E, Wilson LK, Benrimoj SI. The search for business viability. Aust J Pharm. 2008;89:68–9.Google Scholar
  26. 26.
    Verdu-Jover AJ, Llorens-Montes JF, Garcia-Morales VJ. Environment-flexibility coalignment and performance: an analysis in large versus small firms. J Small Bus Manage. 2006;44(3):334–49. doi: 10.1111/j.1540-627X.2006.00175.x.CrossRefGoogle Scholar
  27. 27.
    Volberda HW. Toward the flexible form: how to remain vital in hypercompetitive environments. Organ Sci. 1996;7(4):359–74.CrossRefGoogle Scholar
  28. 28.
    Volberda HW. Organizational flexibility: change preservation. A flexibility audit & redesign method. Groningen: Wolters-Noordhoff; 1992. ISBN 978-9001915407.Google Scholar
  29. 29.
    Whiteley AM, Whiteley J. The familiarization study in qualitative research: from theory to practice. Qual Res J. 2006;6(1):69–85.Google Scholar
  30. 30.
    Berg BC. Qualitative research methods for the social sciences. Boston: Allyn & Bacon; 1989. ISBN 978-0205379057.Google Scholar
  31. 31.
    Phillips S. The role of community pharmacist: The pharmacist’s view. In: Phillips S, Delamont S, Temple D, editors. Qualitative research in pharmacy practice. Aldershot: Avebury; 1996. p. 7–22. ISBN 978-1859722114.Google Scholar
  32. 32.
    Thomas M, Bloor M, Frankland J. The process of sample recruitment: an ethnostatistical perspective. Qual Res. 2007;7(4):429–46. doi: 10.1177/1468794107082300.CrossRefGoogle Scholar
  33. 33.
    Kvale S. InterViews: an introduction to qualitative research interviewing. Thousand Oaks: Sage Publications; 1996. ISBN 0-8039-5819-6.Google Scholar
  34. 34.
    Groleau D, Zelkowitz P, Cabral IE. Enhancing generalizability: moving from an intimate to a political voice. Qual Health Res. 2009;19(3):416–26. doi: 10.1177/1049732308329851.CrossRefPubMedGoogle Scholar
  35. 35.
    Bowen GA. Naturalistic inquiry and the saturation concept: a research note. Qual Res. 2008;8(1):137–52. doi: 10.1177/1468794107085301.CrossRefGoogle Scholar
  36. 36.
    Reijonen H, Komppula R. Perception of success and its effect on small firm performance. J Small Bus Enterp Dev. 2007;14(4):689.CrossRefGoogle Scholar
  37. 37.
    Sclavos K K. Guild digest latest. Aust J Pharm. 2008;89:16.Google Scholar
  38. 38.
    Laforet S. Size, strategic, and market orientation affects on innovation. J Bus Res. 2008;61(7):753.CrossRefGoogle Scholar
  39. 39.
    Plunkett W. All aboard or miss the boat. Aust J Pharm. 2009;90:34.Google Scholar
  40. 40.
    Tann J, Blenkinsopp A, Platts A. Teaching and learning at the leading edge: leading edge practitioners in community pharmacy. Manage Learn. 2001;32(2):163–79.CrossRefGoogle Scholar
  41. 41.
    Mullen R. Skill mix in community pharmacy: exploring and defining roles of dispensary support staff. London: Royal Pharmaceutical Society of Great Britain; 2002. http://www.pprt.org.uk/Documents/Publications/Skill_mix_in_community_pharmacy.pdf. ISBN 0-9544961-6-7.
  42. 42.
    The Pharmacy Guild of Australia. Australia’s Unique System of Community Pharmacy. The Pharmacy Guild of Australia. 2009. http://www.guild.org.au/uploadedfiles/National/Public/Fact_Sheets/community_pharmacy.pdf. Accessed 17 May 2009.
  43. 43.
    Benrimoj SI, Roberts AS. Providing patient care in community pharmacies in Australia. Ann Pharmacother. 2005;39(11):1911–7. doi: 10.1345/aph.1G165.CrossRefPubMedGoogle Scholar
  44. 44.
    The Pharmacy Guild of Australia. Guild digest: a survey of independent pharmacy operations in Australia financial year 2005–2006. Canberra: The Pharmacy Guild of Australia; 2007.Google Scholar
  45. 45.
    New South Wales Government. Pharmacy Practice Act 2006. 2006. http://www.austlii.edu.au/au/legis/nsw/consol_act/ppa2006165/. Accessed 30 July 2009.
  46. 46.
  47. 47.
    Annabel B. Sun Tzu: know yourself, know your enemy. Aust J Pharm. 2005;86:905.Google Scholar
  48. 48.
    Roberts S. Bottom line will bottom out: Sclavos. Pharm News. 2008;24 April, 1–2.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Eleonora Feletto
    • 1
  • Laura K. Wilson
    • 1
  • Alison S. Roberts
    • 2
  • Shalom I. Benrimoj
    • 1
  1. 1.The University of SydneySydneyAustralia
  2. 2. BrightonAustralia

Personalised recommendations

Cite article

Buy options