Advancing clinical pharmacy practice

This Context Statement contains critical descriptions of my academic and professional outputs as a hospital clinical pharmacist and senior pharmacy leader, over the period 2007 to 2017, with some antecedents prior to 2007. Clinical Pharmacy has a main aim of optimising safe, appropriate and effective medicines use, for individual patients and organisations as well as system-wide. The Public Works presented here centre around four interrelated themes regarding clinical pharmacy – measuring and improving standards and quality of care; prescribing, prescribing practices and prescribing safety; innovative practice within legal and ethical frameworks; the impact and outcomes of clinical pharmacy. A unifying premise is my aim of advancing clinical pharmacy practice.
The concept of measuring to improve standards and quality of clinical care has progressed considerably over the past 15 years. I present my contributions to this - developing, implementing, measuring and disseminating clinical pharmacy quality and performance indicators, as well as benchmarking and quality improvement initiatives.
The chapter on prescribing encompasses the impact of electronic prescribing on pharmacy practice; the formal and informal roles of hospital pharmacists as prescribers; and a practice model I developed for pharmacists to practice as both specialist and generalist prescribers. I also discuss my research into inappropriate prescribing.
The innovative practices in Chapter Four include the introduction of different models of practice to improve patient care and medicines use, with significant focus on a specific initiative - redesigning the discharge medication prescription pathway. Chapter Five highlights other work which I undertook to demonstrate the potential of hospital clinical pharmacy to improve outcomes.
Throughout my professional career I have promoted the development of research capability within hospital pharmacy, to better improve patient care. In the concluding chapter, I draw from other professions to conceptualise a model of integrating professional practice, theory and research. Pharmacy Praxis is a philosophy which bears further development, in order to continue the progress of clinical pharmacy.