title: Pharmacist work stress and learning from quality related events.
abstract: Among the many stresses faced by pharmacy staff, quality related event (QRE) learning can be among the most significant. In the absence of a supportive organizational culture, the potential for blaming individuals, versus identifying key process flaws, is significant and can be very intimidating to those involved in such discussions and may increase an already stressful work environment.
  
  
  
  This research develops and tests a model of the relationship between the work stress faced by pharmacists and the extent of QRE learning in community pharmacies. Building upon recent research models that explore job characteristics and safety climate, the model proposes that work stress captured by the effort that the pharmacist invests into job performance, the extent to which the pharmacist is rewarded for such efforts, and the extent of pharmacist work-related commitment to their job, influence pharmacist assessment of the working conditions within their community pharmacy. It is further proposed that working conditions influence the extent of a blame culture and safety focus in the pharmacy, which, in turn, influences organizational learning from QREs.
  
  
  
  This research formed part of a larger study focused on QRE reporting in community pharmacies. As part of the larger study, a total of 1035 questionnaires were mailed to community pharmacists, pharmacy managers, and pharmacy owners in the Canadian province of Saskatchewan during the fall of 2013 and winter and spring of 2014. Partial least squares (PLS) using SmartPLS was selected to test and further develop the proposed model. An examination of the statistical significance of latent variable paths, convergent validity, construct reliability, discriminant validity, and variance explained was used to assess the overall quality of the model.
  
  
  
  Of the 1035 questionnaire sent, a total of 432 questionnaires were returned for an initial response rate of approximately 42%. However, for this research, only questionnaires from staff pharmacists were used thereby reducing the number of usable questionnaires to 265. The final model highlights that pharmacist work stress greatly influences perceptions of the working conditions in the pharmacy (R(2) = 0.52), which, in turn, influence assessments of the safety focus (R(2) = 0.27) and blame culture (R(2) = 0.14) in the pharmacy. The model also found that the extent of a safety focus and blame culture within the pharmacy both influence the extent of organizational learning from QREs (R(2) = 0.44) within the pharmacy.
  
  
  
  In an environment where financial rewards are not always possible, ensuring that pharmacy staff feel respected and encouraged in providing safe care may help enhance QRE learning. Given the importance placed on organizational reporting of, and learning from, QREs in many jurisdictions in North America, the findings from this study suggest that a number of working conditions and perceptions of blame culture and organizational safety need to be explored before such processes can become entrenched in work flow.
authors.affiliation: St. Francis Xavier University, Gerald Schwartz School of Business, P.O. Box 5000, Antigonish, Nova Scotia, Canada B2G 2W5. Electronic address: tboyle@stfx.ca.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Boyle
authors.affiliation: Dalhousie University, School of Nursing, P.O. Box 15000, Halifax, Nova Scotia, Canada B3H 4R2.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bishop
authors.affiliation: St. Francis Xavier University, Gerald Schwartz School of Business, P.O. Box 5000, Antigonish, Nova Scotia, Canada B2G 2W5.
authors.forename: Bobbi
authors.initials: B
authors.lastname: Morrison
authors.affiliation: Dalhousie University, College of Pharmacy, P.O. Box 15000, Halifax, Nova Scotia, Canada B3H 4R2.
authors.forename: Andrea
authors.initials: A
authors.lastname: Murphy
authors.affiliation: Dalhousie University, Rowe School of Business, P.O. Box 15000, Halifax, Nova Scotia, Canada B3H 4R2.
authors.forename: James
authors.initials: J
authors.lastname: Barker
authors.affiliation: The University of Manchester, Manchester Pharmacy School, Oxford Road, Manchester, M13 9PT, UK.
authors.forename: Darren M
authors.initials: DM
authors.lastname: Ashcroft
authors.affiliation: The University of Manchester, Manchester Pharmacy School, Oxford Road, Manchester, M13 9PT, UK.
authors.forename: Denham
authors.initials: D
authors.lastname: Phipps
authors.affiliation: St. Francis Xavier University, Gerald Schwartz School of Business, P.O. Box 5000, Antigonish, Nova Scotia, Canada B2G 2W5.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mahaffey
authors.affiliation: University of Cincinnati, James L Winkle College of Pharmacy, 3225 Eden Avenue Cincinnati, OH, 45267, USA.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: MacKinnon
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008508:Medication Errors / Q000523:psychology*; D008962:Models, Theoretical; D015279:Organizational Culture; D010595:Pharmacists / Q000458:organization & administration* / Q000523:psychology / Q000592:standards; D015203:Reproducibility of Results; D012525:Saskatchewan; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Community pharmacy; Partial least squares; Quality related events; Safety culture; Work stress