WEBVTT
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Welcome to the AJP podcast,
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a podcast for pharmacists by pharmacists where we discuss current
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events, relevant topics, and emerging issues. I'm your host, Carlene McMaugh,
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and together with the AJP,
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I'm bringing you the opinions and expertise of different pharmacists to discuss
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their views and insights on topics relevant to pharmacists.
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Please like and rate each episode and subscribe to the podcast so you don't miss
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an episode.
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So thank you Michael Dooley for making the time to speak with me today.
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Can I just ask you to tell us about yourself?
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Yes, thanks Carlene, look, I'm Michael.
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I'm the director of pharmacy at the Alfred Hospital
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in Melbourne,
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which is a large hospital network with the
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Alfred Hospital corporate hospital,
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centering hospital and services for Melbourne sexual health and a range of
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outreach programmes.
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So it's a very large health service and I look after the pharmacy
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services across all those campuses.
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And we have a range of services that are both focusing on our patients who are
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within the hospital,
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but also our ambulatory patients who may be being treated in the home or
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through our outpatient clinics and such.
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And I'm very fortunate I work alongside a great
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team of advanced practitioners from
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interns through to residents,
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through to very specialised pharmacists working across a whole range and working
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alongside some great other practitioners, our nursing colleagues,
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medical and other allied health colleagues who we work very closely with.
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I also have a position as a professor of clinical pharmacy within Monash
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University and that is a great collaboration which allows us to be
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able to also collaborate on research projects.
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And I supervise a number of PhD students as well.
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And I've been fortunate enough to sit on a range of working groups
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and reference groups and committees across
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Australia and in Victoria focusing on medication use and shortages.
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So I have a reasonable
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portfolio that includes both developing practice and supporting practitioners
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and having input into medication use and safety across a range of
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areas.
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Thank you.
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Can I please ask you to share some of the key challenges facing the hospital
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sector, such as transitions of care?
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Yeah, look, I think the hospital sector,
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like all sectors has a range of challenges and they probably
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encompass everything from
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the challenges associated with expectations,
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both from patients and their families,
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and also expectations of practitioners.
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It's a challenging environment just because of the nature of the
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diversity that we see in hospitals and that may be from outpatient clinics
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through to intensive care units, emergency departments,
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and the services that are provided both in very large acute
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services through to those that are rural and regional.
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So the challenges are there around the complexity associated with,
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I mean the services that are provided
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and the nature of the pressures that are
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associated with those, whether that be just due to workload,
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just due to the diversity of patients,
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just due to the challenges of providing care across a range of settings
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as those patients transition into hospitals and out of hospitals.
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So there are a range of challenges and we've seen this
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continuing to grow as our services get more complicated as patients get
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more complicated as treatments get more complicated.
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Thank you.
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Can you tell me more specifically as well about some of the challenges specific
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to pharmacists,
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whether it be quality use of medicines and medical medicine safety working in
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the sector?
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Yeah, look, I think the challenges of pharmacists
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fall into a number of areas.
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I mean there's the challenges of the system that we have to work in.
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We are just one member of one cog of a very big system
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playing an very important role.
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But there's the challenges of the system and how it's designed and how hospitals
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are designed and how our funding is designed and how the
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PBS is designed. So it's working within that system where
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we work alongside a diverse group of other health practitioners.
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So it's the challenges in that system.
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I think there's the expectations of patients and their carers and their
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families as to
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the care they would like to be provided.
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We are all at some stage patients ourselves and
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patients rightly should have the choice associated with their care and be able
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to choose what happens to them as best they can.
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And so I think that's a real challenge is how do we balance the system and how
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do we balance the needs of the patients and the expectations of the patients.
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And then there's the challenges associated with being the complexity of care.
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As we see
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more patients presenting with more complex conditions, comorbidities,
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we see the treatments,
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the medicines getting more and more complicated every day,
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the range of therapies available, the combinations of therapies,
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how we administer them, how we dose, how we educate,
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growing,
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and then we see our scope of practise also expanding.
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And with that comes how do we educate, how do we make sure we support
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the individual pharmacists who are providing those,
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providing those roles across so many different settings.
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And then I think it's how do we look after our workforce?
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How do we make sure their role is and their work is done in a way that
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we look after their wellbeing, that we recognise them, that we develop them,
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that we provide those support.
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So I think they're all the key things that go into quite a
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degree of
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complexity associated with the individual pharmacists providing care is the
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system, is the patient's, is their role,
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and then is how we support them and of course the medications
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that go with that.
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Thank you. So I thought I'd ask you more specifically about the
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P-S-A-C-S-I.
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So what made you decide to chair the PSA leadership group?
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Look, I think all the things we've been talking about at the moment
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show that those challenges that we see,
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I'm in a fortunate position that I've been able to
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see those challenges that are faced by pharmacists, which we've just discussed.
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And I think we need to be able to support
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pharmacists to be able to take on those responsibilities and to be able to
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practise safely and to be able to provide care that we want to
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provide, but do that in a way that we still look after their wellbeing,
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that they're remunerated appropriately,
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that we put the supports in place for them to practise.
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So I think it's motivated me to be involved
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in hospital pharmacy practise group such as this is really,
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there's so much we want to be able to do,
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there's so much that there's so many opportunities,
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but we need to be able to support practitioners in undertaking those
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roles.
And a group such as this I see as being
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able to work through how do we develop those services,
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how do we develop the practitioners, but how do we support them?
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And I think the key bit that I think is interesting to me is how do we put those
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supports in place to be able to
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grow the opportunities for pharmacists to practise and to impact on
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patient's care and on the care that Australians receive.
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But how do we do that and how do we help them do that in a supportive manner,
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whether that be through educational programmes,
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whether that be through advocacy, whether we do that through changes in policy,
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I think
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those individuals who are in leadership positions with that
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comes the responsibility to really support those going forward.
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And I just see it as a way of contributing.
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Thank you.
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So you have a great panel of pharmacists in the hospital pharmacy practise,
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CSI with you.
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Can you please tell me about them and their experience in pharmacy as well?
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Yeah, look,
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I mean that's always one of the wonderful things in putting together
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like-minded individuals who are very passionate about what they're
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doing and very passionate and being able to contribute and help.
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And there's a number of the team that's been
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put together to start the work in this space In regards to this group is
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pretty diverse. I mean,
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we've got a number of people
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who have led and continue to lead hospital pharmacy
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programmes.
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We have Ian Coombes rom Queensland who's been instrumental over the
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long time in leading and developing services.
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We have Richard who's in
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South Australia leading the pharmacy,
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I suppose pharmacy programme there and doing wonderful
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work, Lisa,
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who many of the few will be know of
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Lisa's long time and passionate involvement in education and
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advancing services, not only across all sectors.
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And then we have people who have probably been around a little less time
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and getting that flavour of some people who have got probably earlier on in
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their career who are working across a
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range of things, a range of areas, whether that be community medication reviews,
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hospital settings,
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is getting that balance of people who have been around for a while.
But
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also I think as important is the insight and the
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engagement of those that are developing in the services who
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have, I suppose,
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fresher eyes that can often give those
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insights that are even more important than some of us who have been possibly in
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roles for a long period of time. So the group
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that we put together is trying to get a mix of those that are working in the
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acute sector, hospital acute sector.
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We have Bavini who's from the Northern Territory are working across all of the
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Northern Territory. So we've been trying to get a flavour of those that have
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got a lot of experience versus those that have got some new eyes,
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those that are in different states, those are in private and public sector
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and those that are early career.
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So I think it's a wonderful group to be working with
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and no doubt there'll be others that will come on board that will be able to
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support
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and challenge the thinking in regards to what we should be
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doing for hospital practise going forward.
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Thank you.
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Can you please share with us what you hope to achieve through the leadership
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group?
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I think I need,
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the key bit I think is working through
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ways to support
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hospital pharmacy practise and the transitions associated with practice.
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I mean hospital pharmacies includes those aspects associated
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with looking after patients who are hospitalised,
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but also many of our patients are transitioning either through
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coming into hospital or leaving hospital,
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going into other settings or in ambulatory care.
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So really the main,
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what I would like to achieve I think is been able to put like-minded
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individuals together to really set a bit of a vision
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for the organisation and for others. That's the key bit I think,
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is
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developing a vision and engaging with those that got
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their, I think heart and soul in the space. We really want to
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have a vision work alongside and with those that have
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got their heart and soul in working across hospitals and in those
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transition points so that we can work through what's the
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best way to support practitioners.
If we can support practitioners,
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we can expand their roles and responsibilities, we can provide care better,
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which is I think what we'd all like to achieve.
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But also we'd like to achieve that by being looked after in the workplace,
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be remunerated the right way to be respected and
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have our role within those multidisciplinary
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groups work alongside other practitioners.
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So I think it's really about having a group that can help set the
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vision
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and can work alongside those who are passionate about what they do to
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support both the services, but most importantly support the practitioners,
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the pharmacists who are providing those services so that they can do the
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things they want to do and be supported to do that.
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Can you tell me why in your opinion it is important to have an organisation that
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represents all areas of pharmacy practice?
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I think it's really, I think, look,
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I work in a hospital and sometimes we get very,
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very focused on what happens if it's inside the four walls.
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We know that
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care is provided across all the sectors.
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And what we do in hospitals is what happens to patients
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in the ambulatory setting in their home,
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in wherever they live is incredibly important.
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Those links
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that follow the patient journey are credibly important.
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The practitioners who work across those settings,
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whether it be in community practise, whether it be
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gps, whether it be residential age facilities,
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wherever those links are incredibly important. I think
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we need to be able to continue to develop those links.
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We need to continue to be able to develop services that follow the
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patient.
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We need to be able to continue to support practitioners who work
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across the different settings.
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And so I think a real strength here is
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this group will be able to look more
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broadly looking at focusing on our patients
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and how we practise in the hospital setting,
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but most importantly how we integrate those practices,
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how we have those collaborations across,
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not just the hospital setting. So I think from the organisational perspective,
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I think is fantastic to be able to work
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and collaborate with individuals across such a
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wider space. Our patients
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most of the time will
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be in hospitals for part of their care,
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but most of the patients that we look at is they're not with us in the four
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walls, they're outside.
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So now I think and having the ability to work within PSA where
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there is that ability to advocate,
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influence and support practitioners more widely is a fantastic strength.
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Can you tell us about pharmacists working across all sectors?
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How can they better collaborate for better patient outcomes?
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Look, I think the most important thing,
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I think one of the most important things is having and understanding what
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everyone else does, what everyone else's role is.
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I think we learn more,
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we often assume a lot about others and we don't always
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understand their challenges or even their
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expertise as pharmacists, we often
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think that others don't understand what we know and what we do.
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And I think that's probably right.
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We might not know exactly what a GP does,
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or we might not know the challenges associated with nurses who work in
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different settings. We have assumptions.
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So I think what's really important is that we get to,
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I think the first thing is understanding what we do,
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but also understanding what others do. What are their expertise,
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what are their challenges? And by understanding that we can then
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be able to collaborate where we can share our expertise and we can fill gaps.
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But also it allows us to understand where there's a commonality.
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The challenges for an individual practitioner,
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whether that be a nurse or a pharmacist,
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they're often the same degrees of isolation.
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So I think understanding
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within pharmacy and what pharmacists do in different settings is probably the
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first place. We often don't,
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people often working in hospitals don't necessarily understand the challenges
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associated with someone working,
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doing reviews by themselves. As an isolated pharmacist,
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a community pharmacist may not necessarily fully understand the challenges
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associated with working in a hospital.
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So I think breaking down some of those barriers where people can share their
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experiences, understand their expertise of others,
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and understand that commonality of the challenges is a really good place to
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start.
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And I think then I've noticed when working with
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medical staff, working with nursing staff,
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I probably learn learning more about what they do.
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I learn more about what my role is and where I can add value rather than that
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thinking, that's where I add value.
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So I think understanding what other pharmacists do in other settings is
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incredibly important. And I think understanding
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what other practitioners do and their challenges is incredibly important as
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well.
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So as you've mentioned as well,
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there has been increasingly diverse roles for pharmacists working across all
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sectors. And what do you think is needed to support them?
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I think most people,
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when you ask pharmacists to explore what are their
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challenges, probably
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some of the key challenges is how do people keep up to
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date?
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And what I mean by that is there's keeping up to date around therapeutics,
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medications, and that is one component.
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Keeping up to date about how practise is changing I think is incredibly
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important.
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I think the other challenges around
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having the workforce that is supported.
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So for example, making sure that people are able to
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be supported in regards to their own practise,
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be supported around where their practise fits in with others,
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but at the same time be supported. So they've
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getting remunerated the right way,
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but also that they've got that they're wellbeings looked after,
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that they're getting supported,
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not only relating to their knowledge or practises as a pharmacist,
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been supported as an individual.
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Is their wellbeing taken into account?
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Is the workload reasonable?
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If they're in challenging situations, are they being supported in regards to
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their health? So I think
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there's components associated with the individual knowledge and therapeutics
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where practises is changing,
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where the system is changing, whether that be technology,
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telehealth funding.
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So I think it all goes back to the complexity of the environment.
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There's the complexity associated with the environment,
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there's the complexity associated with the therapeutics,
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there's the complexity associated with patients,
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there's complexity associated with medications, and all those four things
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is the real challenge.
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And I guess I'm going to ask you why pharmacists should join the CSI.
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Look, I think it's like everything.
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If you want to set a vision and you want to be able to take into account
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what people really want and need and
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to support their professional practise,
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you need input. And what you need is
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people contributing their own vision,
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people contributing their perspectives.
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If we only listen to what we've seen ourselves,
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we we can get a very narrow perspective.
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I think what we need to do is,
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and what we want with this group is to be able to support
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practitioners, but also influence practise going forward. To do that,
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we need to understand what people need,
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understands their challenges, understand their priorities,
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and that way you can then
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work together to develop a shared vision of where we want to get to,
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and then use the expertise of the practitioners that have all
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that understanding of the challenges that faces them.
So I think
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it's really inviting individuals that
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want to shape the future of practise,
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who want to
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contribute to that, to have input.
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So we need to hear from others,
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we need to broaden the expertise.
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We need to focus on what people need. And to do that we actually,
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you need to hear
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what those who have got their heart and soul
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into this area of practise.
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And we need their guidance. We need their passion,
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we need their collaborations to actually determine the
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vision and then shape the future. And so I would be saying to people,
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if you're interested in this space and you want to be able to influence it and
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you want to be able to contribute to it, then get involved. And.
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I might ask you one more question.
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Where would you hope to see the hospital practise CSI in a year's time?
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I'd like to see it being relevant.
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I think it's okay to put a team of people with
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a lot of experience together.
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I would like to see that it's engaging,
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that if those that are working in this space are trying to influence it,
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that they see this as a way forward to contribute.
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So I think in a year's time it would be
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are we hearing people's voices? Are we hearing
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what people would like to achieve?
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And are people contributing to that
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in a positive way and in an exciting way and in a
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passionate way. You can't solve everything quickly, you can't
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do everything. But I think in a year's time,
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I think it would be good that people believe there is a vision and there is
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an opportunity to influence the future. So that would be,
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I think the optimistic, big picture
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perspective I would like to see
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and have some surprises.
I'd like to be surprised by what people
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want and want to achieve.
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I'd love to see people who are coming out of the woodwork, so to speak,
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who have got some expertise, who have got some insight,
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who have got some experience, who have got some passion,
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who maybe haven't necessarily been able to
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contribute in the way they would like to, and is giving them an opportunity.
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There are wonderful,
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fantastic pharmacists out there doing great things who want to support
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others,
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and it would be lovely to be able to see this as an opportunity for
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those individuals and the individuals I'd like to work alongside being having
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that chance to work together.
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Fantastic.
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Can I ask you if there's anything you'd like to share that I haven't asked you?
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No. Look, I think
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this is all about how do we continue to shape
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practise and going forward.
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I think that's the key bit here. And I think the most important thing here
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is having input from those who
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are working and contributing to the care of patients across this sector
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and getting them engaged and giving them a voice and
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helping put together an approach where there's the potential to be able to,
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I dunno, shape and influence the future is the key bit for me.
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And I think that's
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practitioners who have been around for a while who have had a lot of experience,
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but also those that are new practitioners and those that trying
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to
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improve care and practise.
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So we want to see people getting involved
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across the breadth and depth of the profession.
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And I'm pretty excited that there will be,
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I would like to be very optimistic that there's going to be
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a great opportunity to put people together to be able to make a difference.
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Thank you. Thank you so much.
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We hope you've enjoyed this episode of the A JP podcast.
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