Progress 10/01/19 to 09/30/21
Outputs
Target Audience:The following groups constitute the main target audiences for this project: (1) staff and administrative leadership in inpatient and outpatient health care settings based in Minnesota, e.g., M Health Fairview, Essentia Health, Hennepin Healthcare, Community-University Health Care Center, Indian Health Service; (2) community-based retail pharmacies, e.g., Thrifty White, CVS, Walgreens; and (3) graduate students in pharmacy and social work at the University of Minnesota. 1 - Staff and administrators include: Clinical Pharmacists, Pharmacy Managers and Directors, Clinical Social Workers, Care Coordinators, and Case Managers. 2 - Efforts were made to reach retail pharmacists in the community, especially in Greater Minnesota, so that rural communities would be included in the study. 3 - More than 60 graduate students enrolled in a program evaluation courses and an integrated behavioral health training program benefitted from this project because it was used as an exemplar of doing mixed methods research and the benefits of interprofessional collaboration and communication. In May 2021, a New York Times article described how four corporations (CVS, Walgreens, Rite Aid, and Walmart) are engaging in a variety of programs that would connect their customers to behavioral health and counseling services. Currently, many of these programs are in a pilot stage in specific states. It was exciting to see these large corporations acknowledging the importance of connecting pharmacy and social work/behavioral health services to support their customers. The current project has the potential to offer in-depth empirical data that could potentially guide the development and implementation of social work/behavioral health services to pharmacy customers in Minnesota and across the country. (Source: New York Times, May 7, 2021, "Therapy on Aisle 7: Retailers Are Entering the Mental Health Market"). Changes/Problems:The main problem encountered during this project was getting our populations of interest (i.e., social workers and pharmacists) to participate in data collection activities in a timely manner. We were ultimately very successful in reaching our target of 40 qualitative interviews, which provided a wealth of excellent information, but our survey activities have been delayed, due in part to the COVID-19 pandemic. We are now on target to complete our statewide survey of all licensed pharmacists and social workers by February 2022. What opportunities for training and professional development has the project provided?The project has provided valuable opportunities for training pre-licensure students. Specifically, aspects of the study have be shared with graduate students and fellowship trainees at the University of Minnesota. The majority of these students will enter the Minnesota health care workforce and use their training to provide services to a wide range of patients throughout the entire state, both urban and rural communities. In said trainings, it has been important to explicate the benefits and challenges of interprofessional collaboration so that these pre-licensure students are well-prepared when the begin their careers as practitioners. After the survey data are collected, we will be well-positioned to offer a free training webinar through the Center for Practice Transformation (CPT) at the University of Minnesota - Twin Cities. CPT offers a variety of training opportunity for clinical providers, including a free monthly webinar series that provides one continuing education unit at no charge to attendees who complete a post-test and short evaluation. The CPT webinar series attracts a large cross-section of clinicians from across Minnesota and attendance at these webinars has sometimes exceeded 2,000 participants. We will also offer presentations to representatives of CVS, Walgreens, Rite Aid, and Walmart to share what we learned about the benefits and best practices associated with collaborations between pharmacist and social workers. How have the results been disseminated to communities of interest?Dissemination plans are on hold due to COVID-related delays in data collection. Once dissemination of findings is possible, we plan to offer a free training webinar, as well as engage with pharmacy representatives to share findings and implications for best practices. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
The major activities for this project included (a) the completion of 40 qualitative interviews (24 pharmacists and 16 social workers) and (b) the development of a survey instrument based on the data obtained from the 40 interviews. Participants in the interviews were employed in 11 Minnesota counties. The urban counties included Hennepin, Olmstead, Ramsey, and St. Louis; the rural counties included Beltrami, Cass, Carlton, Kandiyohi, Mahnomen, Renville, and Yellow Medicine. Pharmacists were employed in community pharmacies (n=8) and large health care systems (n=16). Social workers were employed in diverse settings including hospitals (n=12), community-based clinics (n=2), hospice (n=1), and alcohol and drug treatment (n=1). On average, pharmacists had 11 years of work experience (range = 2 to 38 years) and social workers also had 11 years of work experience (range = 2 to 35 years). Participants provided narrative accounts that explicated the benefits and challenges associated with collaborations between pharmacists and social workers. Three overarching themes were identified based on an in-depth analysis of the transcripts: (1) differential role perceptions in collaborative work (e.g., advocate, educator): (2) building the interprofessional communication and collaboration pathway (e.g., direct vs. indirect communication, cultivating a trusting relationship to bolster collaboration, developing a shared understanding of a patient); and (3) maximizing benefits to the healthcare system (e.g., reduced cost, efficiency, holistic care, care team member well-being). Each of these themes highlights innovative ways that pharmacists and social workers can engage purposefully in interprofessional collaborative practice. These findings will be used to: (a) help develop curricula to expand and strengthen pharmacists' and social workers' interprofessional collaborative practice; (b) focus on the importance of understanding disciplinary roles and areas of clinical and psychosocial expertise; (c) identifying strategies for effective communication between pharmacists and social workers; and (d) improve patients' health outcomes through effective knowledge sharing. Further, these findings documented how collaborative work between pharmacists and social workers has the potential to enhance the patient experience, improve medication adherence through holistic assessment and clear communication between providers, and benefit the healthcare system by implementing efficiencies that result from collaboration and creating team practices that support care provider well-being. Given delays due to the impact of COVID on the work demands of social workers and pharmacists in Minnesota and across the nation, the survey phase of this project (Goal 2, Objectives 2 and 3) will be completed by the end of February 2022. The online survey was developed based on the qualitative interviews, reviewed by experts in the field to assess its face and content validity, and prepared for dissemination in Qualtrics. Mailing lists of licensed pharmacists and social workers have been obtained by state associations and prepared for use. In order to get the best response rate, it was advised that we postpone our launch until January 2022 given the COVID-related complexities being experienced by pharmacists and social workers in their workplaces.
Publications
- Type:
Other
Status:
Published
Year Published:
2021
Citation:
Merighi, J. R., Hager, K., Cerda, J., & Betz, T. (2021, September). Exploring collaboration between pharmacists and social workers: A qualitative study. Poster presented at the NEXUS Summit 2021, Minneapolis, MN.
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Progress 10/01/19 to 09/30/20
Outputs
Target Audience:The following groups constitute the main target audiences for this project: (1) staff and administrative leadership in inpatient and outpatient health care settings based in Minnesota, e.g., M Health Fairview, Essentia Health, Hennepin Healthcare, Community-University Health Care Center, Indian Health Service; (2) community-based retail pharmacies, e.g., Thrifty White, CVS, Walgreens; and (3) graduate students in pharmacy and social work at the University of Minnesota. 1 - Staff and administrators include: Clinical Pharmacists, Pharmacy Managers and Directors, Clinical Social Workers, Care Coordinators, and Case Managers. 2 - Efforts were made to reach retail pharmacists in the community, especially in Greater Minnesota, so that rural communities would be included in the study. 3 - More than 50 graduate students enrolled in a program evaluation course and an integrated behavioral health training program benefitted from this project because it was used as an exemplar of doing mixed methods research and the benefits of interprofessional collaboration and communication. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?At this stage, the project has provided valuable opportunities for training pre-licensure students. Specifically, aspects of the study have be shared with graduate students and fellowship trainees at the University of Minnesota. The majority of these students will enter the Minnesota health care workforce and use their training to provide services to a wide range of patients throughout the entire state, both urban and rural communities. In said trainings, it has been important to explicate the benefits and challenges of interprofessional collaboration so that these pre-licensure students are well-prepared when the begin their careers as practitioners. How have the results been disseminated to communities of interest?Results have been disseminated to communities of interest, primarily to graduate students. As we gather more data from the statewide survey, we will expand our reach to clinicians and administrators in health care systems, as well as pharmacists in retail settings. The COVID-19 pandemic has presented some challenges in terms of accessing all of our communities of interest. However, with the rollout of effective vaccines and the possible easing of social distancing restrictions in 2021, we will have greater opportunities to reach a broad audience of key stakeholders in Minnesota. What do you plan to do during the next reporting period to accomplish the goals?The next reporting period will expand on Goal 1 (Objective 1) to further articulate barriers and facilitators to interprofessional collaboration between pharmacists and social workers. In addition, we will address Goal 2 (Objectives 2 and 3). Specifically, in the next reporting period, we will summarize findings from a Minnesota state survey of licensed pharmacists and social workers and focus on the development of a brief scale that will assess interprofessional collaborative practices between these two professional groups. The survey findings will be combined with the qualitative interview data gathered in the previous reporting period to help inform the development of teaching modules for pharmacy and social work students. With regard to dissemination efforts, we plan to write two manuscripts - one based on the qualitative interviews and one based on the statewide survey - for peer-reviewed journals that will reach a broad audience of practitioners and researchers. In addition, we plan to share our study findings with members of state-level pharmacy and social work associations because it is anticipated that the study findings will motivate pharmacists and social workers to re-examine their practices so that interprofessional collaboration and communication is enhanced. More specifically, they will consider ways to create meaningful collaborations so that their patients can achieve optimal health outcomes.
Impacts
What was accomplished under these goals?
Goal 1, Objectives 1: In the current project period, we conducted 36, in-depth qualitative interviews with 20 pharmacists and 16 social workers. Analysis of the qualitative data is ongoing, and the findings are being used to develop: (1) an online survey that will be administered to all licensed social workers (N=15,000+) and pharmacists (N=4,000) in Minnesota and (2) an interprofessional collaboration scale that can be used to assess the degree to which pharmacists and social workers are collaborating in their work setting. Study participants were employed in 11 Minnesota counties. The urban counties included Hennepin, Olmstead, Ramsey, and St. Louis; the rural counties included Beltrami, Cass, Carlton, Kandiyohi, Mahnomen, Renville, and Yellow Medicine. The pharmacists had a mean of 12.1 (SD=8.3) years of experience; 17 (85%) identified as white and 3 (15%) as Asian; 15 (75%) identified as female; and 4 (21.1%) worked in a retail pharmacy setting. The social workers had a mean of 10.9 (SD=8.1) years of experience; 14 (87.5%) identified as white and 2 (12.5%) as Latinx; 15 (93.8%) identified as female; and 1 (6.3%) had an exclusively managerial role. Preliminary findings based on a thematic analysis of the interview data point to several key barriers and facilitators to interprofessional collaboration between social workers and pharmacists. The top three barriers include: (1) an inadequate understanding of the other professional's scope of practice in a clinical setting; (2) a lack of formal training about other professional's roles and skill set during graduate education; and (3) limited time for collaborative practice in the work setting. The top three facilitators include: (1) having the pharmacist and social worker co-located/integrated in a practice setting; (2) serving on an interprofessional team that values interdisciplinary collaboration and communication and sets expectations for this collaborative work; and (3) having collaborative practice experiences that resulted in positive outcomes for patients. Additional salient themes from the interviews included the following: the primacy of understanding the patient's social context in order to prescribe a practical medication regimen; navigating cultural beliefs and practices to optimize medication adherence; challenging myths about medication use (side effects or death) that impede optimal treatment recommendations; and sequential versus concurrent patient assessment practices in clinical settings. The findings point to nuanced ways pharmacists and social workers have collaborated to benefit the patients' health, as well as structural challenges that do not support consistent or robust teamwork. Note. A major portion of the current project year was spent developing an interview guide based on the literature, pilot testing the data collection instrument to improve its accuracy and completeness, conducing qualitative interviews with participants who work across the state of Minnesota, and data analysis. The COVID-19 pandemic initially slowed data collection because our participant pool -- i.e., primarly clinical providers in the health care space -- was directly impacted given time constraints associated with their roles and responsibilities of providing critical services to patients. Goal 2, Objectives 2 and 3: The next reporting period will focus specifically on Goal 2 and Objectives 2 and 3. Details are provided below in the section on plans to accomplish goals in the next reporting period.
Publications
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