The Impact of Pharmacy Professionals’ Wellness and Working Conditions on Quality and Safety of Patient Care

With growing concerns amongst regulators and pharmacy professionals in Canada about the influence of work environments and business practices on pharmacy professionals’ well-being and quality and safety of patient care, the College of Pharmacy of Newfoundland and Labrador (CPNL) decided to investigate these concerns further and commit to determining its role in this issue as part of its 2023-2026 Strategic Plan.

Anecdotally, CPNL has heard concerns about poor work environments, such as understaffing and inadequate breaks, throughout the province’s pharmacies leading to higher levels of poor well-being amongst pharmacy professionals. In addition, concerns have been raised over business practices such as quotas or time limits for clinical services that negatively impact pharmacy practice by prioritizing business interests over quality of patient care. These concerns have been shared with CPNL through past consultations, including the strategic planning survey and focus groups conducted in 2022 and the safety attitudes questionnaire conducted in 2023, during pharmacy site visits, and through general comments forwarded to the CPNL staff and board members.

To gain more insight regarding the concerns being raised, CPNL developed a survey based on similar surveys distributed by pharmacy regulatory authorities in other provinces across Canada, including the Ontario College of Pharmacists (OCP), the Saskatchewan College of Pharmacy Professionals (SCPP), and the College of Pharmacists of British Columbia (CPBC). The survey, entitled Work Environment and Business Practices in NL Pharmacies, included questions related to breaks and hours worked, staffing, resources and infrastructure, workplace culture, and business practices, as well as professional well-being and aspects of patient care quality. The survey was open from May 6 to June 3, 2024, and distributed to all active registered pharmacy professionals, which included up to 1,289 pharmacists, pharmacy technicians, pharmacy students, and pharmacy interns at that time.

The responses to the Work Environment and Business Practices in NL Pharmacies survey have been analyzed alongside responses to relevant questions in the strategic plan consultation and safety attitudes questionnaire, and a literature review related to pharmacy professionals’ work environments, well-being, and pharmacy business practices. The findings have been published in CPNL’s The Impact of Pharmacy Professionals’ Wellness and Working Conditions on Quality and Safety of Patient Care report.

The analysis establishes that there is an association between workplace conditions, pharmacy professionals’ well-being, and patient care quality, and it is CPNL’s position that it has a role to play in addressing these concerns as part of its responsibility to public protection.

Key Findings

Pharmacy Professionals Are Stressed

The prevalence of stress amongst pharmacy professionals is of significant concern, with 82% of respondents reporting experiencing stress due to their current work environment and 75% reporting experiencing burnout or at risk for burnout. As both the survey results and literature review identified an association between poorer well-being of pharmacy professionals and negative responses to patient care quality indicators, the potential impacts on the quality and safety of patient care need to be explored further.

Pharmacies have inadequate staffing

Among survey respondents, 82% reported that their pharmacy had a staff shortage, including shortages of pharmacists, pharmacy technicians, and pharmacy assistants. More than half of respondents indicated that they believe the staff shortage is due to being unable to recruit qualified staff, while others believe their pharmacy is not willing to hire more staff. Some respondents felt that insufficient staffing complements may affect their ability to practice safely and deliver quality patient care, practice to professional standards, and provide current clinical pharmacy services, which raises concerns about the potential negative impacts to the quality and safety of patient care.

Pharmacy Professionals Are Experiencing Business Pressures

Many pharmacy professionals reported feeling directed or pressured to complete activities in a limited timeframe or achieve certain number or dollar amount targets for pharmacy services either at their current practice site or in a previous workplace. It is not clear from the survey results whether time pressures are primarily caused by inadequate staffing or limits imposed by employers. Regardless of the reason, having insufficient time to complete specific tasks can compromise the quality of the service being provided to the patient.

Patient care quality is at risk of being compromised

With 81% of respondents indicating that they have had to turn away or chose not to provide care for a patient for a professional service due to staffing or time constraints, the potential impacts on access to care is concerning. This is further reinforced by respondents indicating that their pharmacy does not have a sufficient staffing complement to provide current clinical pharmacy services. Additionally, 40% of respondents do not agree that their staffing complement is sufficient to practice safely and deliver quality patient care.

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