JUNE 2023 – When Michael Holland first moved to Bridgewater, N.S., he knew he needed a good pharmacy. At 82 years old, Holland is on eight medications, has a pacemaker and suffers from osteoarthritis and chronic pain. A few bad experiences at the first pharmacy he tried (including lengthy lineups where he was forced to stand, and a mix-up on his prescription) prompted him to the next one on his list: Bridgewater Guardian Pharmacy.
“I saw a difference right away with the service,” says Holland, who frequents the pharmacy at least three times a month. “Once my wife, who has a mobility issue, had an ankle rash and the pharmacist came out to the parking lot to take a look and recommend treatment—they go out of their way to assist patients and I feel so comfortable with all the pharmacists.
The fact he and his wife could easily access immunizations during the pandemic was another bonus. “They had a great setup and everything ran so smoothly,” he says.
Pharmacy owner Pam Kennedy opened Bridgewater Guardian in 2011 to be able to meet the needs of patients like Holland in a more comprehensive way. “When I graduated [from Dalhousie University’s School of Pharmacy] in 2005, my goal was to provide expanded scope services, but I didn’t get much of an opportunity initially,” says Kennedy, who spent her first six years after graduation practising in the Yukon.
When an opportunity came up to open her own pharmacy in Bridgewater near the local hospital—and within a medical building—she jumped at the chance to work within a collaborative healthcare environment. She operated the pharmacy solo for the first two years before gradually adding an assistant. “Now I have a full complement of staff, including another two full-time pharmacists, a part-time pharmacist and three registered technicians,” she says.
Kennedy attributes her success in launching comprehensive pharmacy services to being part of a provincial pilot program called Prescription to Thrive. The program, spearheaded by the Pharmacy Association of Nova Scotia (PANS) and funded in part by the Canadian Foundation for Pharmacy, helped pharmacies implement sustainable services under the guidance of facilitators trained in change management. Under the guidance of one of the original facilitators, Glenn Rodrigues, Kennedy says she and her team got the “confi dence and push needed to dive into providing clinical services.”
They started with advanced medication reviews, and eventually added medication synchronization to streamline dispensing duties and free up workfl ow so staff could focus on other clinical services. Bridgewater is also part of the Bloom program, a fi rst-of-its kind, government-funded community pharmacy initiative to improve mental health and addictions care in Nova Scotia.
“Glenn was there to get us started and provide all the support we needed,” says Kennedy. “I think as pharmacists we want everything to be perfect before starting something new and he proved that sometimes you just need to jump in and make it work as you go.”
When COVID-19 hit, Kennedy leveraged established relationships with local nurses to provide several large vaccine clinics at a local church. “Th rough that we were able to provide immunizations for up to 14 people every five minutes, and up to 1,500 a day,” she says.
The pharmacy also off ers chronic disease management services, including point-of-care lipid and A1C tests and the ability to renew, adapt and initiate prescriptions to treat various conditions. “With so many patients without a family physician all across the country, renewals have been really important for helping alleviate the strain on the emergency department next door,” says Kennedy.
In February this year, Bridgewater Guardian was one of only 12 pharmacies in the province chosen to participate in a one-year pilot funded by Nova Scotia’s Department of Health and Wellness (in partnership with the Nova Scotia Health Authority and PANS) to provide dedicated clinic time for pharmacists to see patients with common illnessesand chronic conditions like diabetes, cardiovascular disease and hypertension. Under the pilot, pharmacists are able to order lab tests, conduct testing (i.e., strep throat, INR etc.) as well as prescribe on site. Th e pharmacy is being compensated $7,000 per month for one year to help cover the cost of additional personnel and space to provide these services, which are free to patients.
“Our clinic operates out of a medical suite on the floor above us so it’s completely separate from the pharmacy and the patients can get that clinic experience,” says Kennedy, noting that the 40-hour-a-week clinic has been fully booked since launching. Appointments are made using the MedMe online technology platform. “Th is is a pilot program, but it’s already garnered a lot of attention from media and government,” says Kennedy. “We hope that governments will see just how much impact we can have on caring for the health of our patients.”
As one of those patients who’s gotten his INR teststhrough the Bridgewater clinic, Holland can attest to the impact first-hand. “I used to have to wait an hour and a half to get my blood test in the hospital and now I’m outin 10 minutes,” he says.
ACTION TIPS FOR CHANGE MANAGMENT
➔ Build a team that is willing to adapt to change and expanded scope; having these services in place will also attract top-notch pharmacy staff.
➔ Volunteer to participate in provincial pilot and demonstration programs (like Prescription to Thrive in Nova Scotia) that can provide a framework and other tools for adopting new services into your pharmacy.
➔ Help patients adjust to appointment-based services. This a new model of practice and pharmacy staff play a key role in educating patients on what to expect and how it will enhance their health care.
➔ Act as a preceptor to future pharmacists and registered pharmacy technicians. It’s an opportunity for learning and growth on both sides, as students are often up to date on the newest pharmacy-related information.