title: Sustainability of pharmacy-based innovations: the case of in-house immunization services.
abstract: OBJECTIVE
  To examine the effect of organization-level factors on sustainability of pharmacy-based in-house immunization services.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Washington State community pharmacies in 2006.
  
  
  METHODS
  Key informants of 490 community pharmacies.
  
  
  METHODS
  Mixed-mode survey; five mail and telephone contacts were used.
  
  
  METHODS
  Effectiveness of champions (i.e., influential individuals within the host organization who actively and continuously promote the service), formal evaluation process, degree of modifications made to in-house services, degree of compatibility between in-house services and the host pharmacy, and sustainability of in-house immunization services were measured and included in the proposed model. Using survey responses, factor analysis and path analysis were performed to determine the relationships among these variables.
  
  
  RESULTS
  Of the 490 survey instruments sent, 1 was undeliverable, 2 were incomplete, and 206 were completed (42.1% response rate). A total of 104 pharmacies that reported offering immunization services in 2006 were included in the analysis. Compatibility, which was defined as the fit between in-house immunization services and the host pharmacy, was the key to sustainability of immunization services. To enhance compatibility between in-house services and the host pharmacy, two pathways were found. First, in-house services underwent formal evaluations and subsequent modifications were made to the services. The second pathway bypassed the adaptation process. Through the second pathway, an operational champion implemented in-house services in a way that was already compatible with the host pharmacy.
  
  
  CONCLUSIONS
  Organizational leaders and practitioners had the potential to sustain in-house services. The key factors included in the model should be incorporated as an integral part of programs planning to foster sustainability of in-house immunization services.
authors: Harrison School of Pharmacy, Auburn University, Auburn, AL, USA. westrsc@auburn.edu
authors: Salisa C
authors: SC
authors: Westrick
authors: Michelle L
authors: ML
authors: Breland
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D017146:Models, Organizational; D009937:Organizational Objectives; D025341:Principal Component Analysis; D015397:Program Evaluation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014861:Washington