Organizational restructuring of regional pharmacy services to enable a new pharmacy practice model.

Models of pharmacy practice are currently the focus of considerable attention within the North American pharmacy profession. In Canada, through the “Blueprint for Pharmacy” initiative, a vision and implementation plan for pharmacy practice in Canada have been established and endorsed by all pharmacy organizations. Three key objectives of the Blueprint are to incorporate technology, to enhance training and utilization of pharmacists and technicians, and to enhance accountability to patients. If pharmacists are to assume greater responsibility and accountability for management of medication therapy, they will need to spend more time performing direct patient care and less time performing technical drug distribution activities. These plans for the profession of pharmacy, when viewed in aggregate, call for transformative change (whereby the culture of pharmacy is changed), rather than transitional change (whereby only a process is changed). However, there is debate in the literature regarding the best approach for initiating and sustaining transformational change initiatives within organizations. This article describes the process followed and lessons learned during a Blueprint-associated transformative change initiative: organizational restructuring and implementation of a new pharmacy practice model within a large health authority.