Caroline Waldron (PhD) is the programme director with the Irish Academy of Continuing Medical Education, (iaCME) which was established over 8 years ago to provide Continuing Professional Development online for healthcare professionals in Ireland. At the time, no other organisation was offering online training for pharmacists. The iaCME team have backgrounds in medicine, the pharmaceutical industry and quality and regulation and have earned a solid, trusted reputation for their focus on accreditation and quality in online learning. The Irish Institute of Pharmacy recently launched a new training module for pharmacists that was developed by iaCME, titled “Managing Quality in Pharmacy Practice”. We talked to Caroline about the challenges facing pharmacists today, and how far online learning has come since they started out.
Could you tell us a bit about the current state of Quality and Quality Management Systems in Irish Pharmacies?
Quality assurance and risk management are regarded as core competences for all pharmacists today with specific competencies identified in the Core Competency Framework for Pharmacists (published 2013). Irish pharmacy is maturing slowly but surely in relation to quality management systems. All pharmacies are subject to inspection by the pharmacy regulator – The Pharmaceutical Society of Ireland, and having documented SOPs and policies in place is a key element of inspection. This can be challenging for small businesses with limited resources. However, most pharmacies do now have documented procedures in place so the focus is beginning to shift to quality improvement and risk management. The emergence of symbol groups (such as Haven, Allcare, Life Pharmacy etc.) is a reflection of the changing environment. One of the key advantages offered by symbol groups (apart from improved buying power) is the provision of support and resources to support this important shift towards ongoing improvement in quality.
How did the iaCME come about?
Continuing professional development (CPD) is a mandatory requirement for all healthcare professionals and also for pharmacists since 2007. I've always had a strong belief in the value of education and training and it's always been something I felt passionate about. I'm a pharmacist but I worked in the pharmaceutical industry managing medical departments in the pharmaceutical industry for many years. My background was in large part medical regulatory affairs but I also worked very closely with the marketing department and training of sales reps, I was always very involved with training. So, in 2008, myself, my husband and a GP - all of us passionate about professional development, decided to set up the Irish Academy of Continuing Medical Education. The aim was to provide best in class, online CPD because nobody else was doing it. There are other options now, we were probably ahead of our time.
With other options available now, what do you think sets iaCME apart?
We have a very strong commitment to quality, so we always work very hard to get everything we do accredited. With online courses, sometimes you don't know what you're getting, so being assured of the quality of the training is something we feeel very strongly about. We put a lot of effort into getting accredited and we are accredited by the European Academy of Continuing Medical Education. As a result, in Ireland, we are able to support the development of the accreditation of training for pharmacists and help to support CPD here. Now we develop accredited modules, tender for particular programmes or people approach us to develop programmes. .
In terms of online courses, what are the benefits above offline alternatives?
Pharmacists and nurses and doctors have long working days generally and they're on their feet and dealing with people all day, and they have their own family life as well. I personally find it very challenging to be able to go out to a meeting or a class at night time, or to be able to take a day off to go to a meeting. In pharmacy, you don't get reimbursed for that. Doctors do but pharmacists don't even though they're obliged to do it. In medicine, if you take a day off for training, you get a locum paid for by the HSE, and you'll get time off to study, but unless a pharmacist's employer says they don't need to take it as a holiday, it will be on their own time. There might be nice employers who do that but it's not obligatory. So online learning offers some flexibility. And online learning has changed a lot too. With web 2.0 technologies, people have much more of an opportunity to discuss things online at a time that suits them and to work collaboratively if the learning system supports that. It's so much more flexible. Web 2.0 technologies are fantastic, before it was just a static presentation that you listen to and that was it.
What are some of the biggest challenges pharmacies are facing at the moment?
There's been a lot of new regulations issued by The Pharmaceutical Society of Ireland and it's a constant challenge to keep up to date with best practice. There's been a lot of change for pharmacists with the economic downturn, there's financial pressure, costs of medicines have been cut, pharmacies' margins are down, they've had to lay off staff and have had to become much better at managing their business. You might have noticed a lot of Life Pharmacies, Haven Pharmacies, or other branded pharmacies emerging too. In order to compete, small independent pharmacies join a syndicate group, and that increases their buying power. They pay something to be part of the group, but also maintain their independence. They also benefit from the support to implement additional services like blood pressure monitoring or cholesterol monitoring but this brings yet another challenge because with additional offerings comes a need to stay up to date with additional training. And there's also new legislation allowing a number of medicines to be made available through pharmacists that previously needed a prescription from a GP, such as the adrenaline injection, ventolin inhalers, naloxone for overdose of opiates, all requiring mandatory training.
How have all of these changes influenced the training iaCME offers?
We initially started out by focussing on drug safety, and still do a lot of work in that area, but the majority of our training is dealing with pharmacy management issues - managing quality, managing risk, retail management, human resource management and helping pharmacies adapt to a changing environment. We have one programme called Fit for The Future, which is sponsored by Pfizer. . That gave us a great opportunity to do a number of training modules focussed on management topics including diverse leadership, management and marketing - areas that are not clinically focussed or drug focussed, but they're areas of competence that are very important to pharmacists and are probably a bit neglected. Theese topics are not addressed in current undergraduate programmes. Pharmacists aren't experts in quality management or risk management, so there's huge learning needs in those areas.
How are the iaCME's programmes developed?
Generally we put together a team of people, based on the learning outcomes we want to deliver. We select people based on the content that we need and their experience in these areas, so every team is different. We work with pharmacists but we also try to include non-pharmacists where appropriate. We develop some of the content ourselves but a lot of the content is created by a programme team and a quality assurance team. We have a go-to quality and risk management system in place for every programme, and generally we lead the quality assurance piece and then gain accreditation.
Regulation and changes must be hard to stay up to date with, are there go-to resources or sites you would recommend to people?
We actually provide a regular CPD training module based on the Health Products Regulatory Authority (HPRA) Drug Safety Newsletter. These are regular newsletters published by the national medicines regulatory body on emerging safety issues with medicines. With their permission, we take the key messages that they issue to doctors and nurses, and we create an online training module based on that, to ensure that the good advice is translated into learnings and implemented into practice, making a difference to patients. There's about eight issues per year and I would regard these newsletters as mandatory reading for all healthcare professionals because it brings people right up to date.
The Irish Institute of Pharmacy recently launched a new training module for pharmacists that was developed by iaCME “Managing Quality in Pharmacy Practice”. Find out more >