title: Practice change in community pharmacy: using change-management principles when implementing a pharmacy asthma management service in NSW, Australia.
abstract: OBJECTIVE
  This study aimed to investigate the application of a research-based change-management tool, the Pharmacy Change Readiness Wheel (PCRW), in practice, and the impact it had on the implementation of an asthma service (Pharmacy Asthma Management Service or PAMS).
  
  
  METHODS
  All pharmacists implementing the PAMS in the state of New South Wales, Australia, were provided training using a custom-designed module explaining change readiness as it applied to the PAMS. This training and a self-administered PCRW checklist were completed before PAMS implementation. Following PAMS service delivery, semi-structured phone interviews were conducted with the pharmacists and any additional staff involved regarding their experiences of change management. Interviews were transcribed verbatim and content analysed.
  
  
  RESULTS
  Thirty seven of the forty five pharmacies who delivered PAMS returned the PCRW checklist (82% response rate) and participants from 29 pharmacies were interviewed (29 pharmacists and six additional staff). Perception of readiness for change before service delivery was remarkably high. From the interviews conducted after service delivery it was evident that systematic management of the practice change using theoretical concepts had not really been undertaken and that many challenges were faced in the implementation of practice change (PAMS). The results of the content analysis from the interviews revealed that factors external or internal to the pharmacy or those related to the individual pharmacist could affect implementation of practice change.
  
  
  CONCLUSIONS
  Change is not as straightforward as it may appear and is a multi-step process over time. Pharmacists were unaware of this. A change-management framework should be applied to specific services with enough flexibility so that pharmacists can individualise them for their pharmacies.
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Feletto
authors.forename: Grace Wan Ying
authors.initials: GW
authors.lastname: Lui
authors.forename: Carol
authors.initials: C
authors.lastname: Armour
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy; D001291:Attitude of Health Personnel; D001315:Australia; D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D019468:Disease Management; D005260:Female; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010594:Pharmacies / Q000458:organization & administration* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires