Scaling the optimizing care model in community pharmacy using implementation mapping and COM-B theoretical frameworks

Abstract Background: There has been increasing evidence that “task shifting,” when a provider entrusting specific responsibilities to another member of their team, can increase care access and may lead to better patient care outcomes. This has been particularly underscored in underserved communities throughout the world where task shifting has led to increased healthcare access in areas of provider shortages. Within the profession of pharmacy, pharmacy technicians are the primary pharmacist-assistants and recipients of pharmacist-delegated tasks. Recently, such task delegation has placed the pharmacist in more direct patient care responsibilities beyond medication dispensing – and one such model with a growing evidence base is the Optimizing Care Model. Through task shifting, the Optimizing Care Model has been shown to reduce medication errors and increase the quantity of patient care services offered by the pharmacist. However, means to spread and scale the model have yet to be reported in the literature. Methods: This article describes the development of a package of implementation strategies designed to facilitate implementation the Optimizing Care Model in a single division of nationwide supermarket pharmacy chain. The Implementation Mapping approach was used to systematically develop strategies. Results: The application of the five steps of Implementation Mapping are described in detail. Implementation objectives, models, and strategies are outlined, as well as the final implementation protocol. There was an overall increase in weeks meeting the 10% Optimizing Care Model threshold; 33% at baseline to 83% after the intervention. Conclusions: The implementation mapping process led to development of multi-faceted implementation strategy for implementing the Optimizing Care Model into community pharmacy practice. The strategy improved Optimizing Care Model implementation. Further research is needed to understand which strategies were most impactful.