title: Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.
abstract: BACKGROUND
  Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals.
  
  
  METHODS
  A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes.
  
  
  RESULTS
  Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities.
  
  
  CONCLUSIONS
  This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants revealed that their sessional employment model increased access to pharmacist-mediated medication management support in rural hospitals. The contracting arrangements and scope of services may be evaluated and adapted in other rural hospitals.
authors.affiliation: School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, Queensland, Australia. amy.tan@uqconnect.edu.au.
authors.forename: Amy Cw
authors.initials: AC
authors.lastname: Tan
authors.affiliation: School of Pharmacy, Curtin University, Bentley, Western Australia, Australia. lynne.emmerton@curtin.edu.au.
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Emmerton
authors.affiliation: School of Pharmacy, Curtin University, Bentley, Western Australia, Australia. l.hattingh@curtin.edu.au.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Hattingh
authors.affiliation: School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia. a.lacaze@uq.edu.au.
authors.forename: Adam
authors.initials: A
authors.lastname: La Caze
mesh_terms: D001315:Australia; D003430:Cross-Sectional Studies; D004651:Employment / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006780:Hospitals, Rural / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration; D020380:Needs Assessment; D009520:New Zealand; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000600:supply & distribution*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D036301:Qualitative Research; D011787:Quality of Health Care
keywords: Accreditation/Standards; Allied Health; Australia/Pacific; Management/Administration; Medical; Nursing; Qualitative Research; Researcher; Workforce