Resumen de An exploration of change in clinical pharmacist roles in the implementation of a venous thromboembolism quality improvement Model
Roxaneh Zarnegar, Parmpreet Kalsi, Olga Badanova, Elizabeth Hardy, Kandarp Thakkar
Introduction: Role reconfiguration in healthcare providers is one of the commonest strategies employed by those who design quality improvement projects (QIP). However the effects of role redesign on frontline staff and the factors that may determine its success or failure have scarcely been studied. Objective: To examine the change processes behind a role redesign initiative from the clinician's viewpoint in a group of hospital clinical pharmacists. Setting: A redesign of the hospital ward pharmacist role as part of a venous thromboembolism prevention QIP. Method: A qualitative research approach was applied. One-to-one semi-structured interviews were conducted by researchers who were independent of the project designers. Data were analyzed using thematic analysis. Results: The process of change in this role redesign initiative has been closely aligned to Fullan's Change Themes. Resistance to change was particularly related to affective responses in clinicians and failures in inter-professional dialogue which could have been avoided with better planning. Possible contributors to sustainability are enhancement of individual professional development and pharmacists' awareness of their positive impact through real-time evaluations. Conclusions: Fullan's Change Themes Model fits well with the change processes inherent in a specific role redesign initiative. Its relevance to other change projects would deserve further study
