Well, we’re not certain if entrepreneurship can ever be called “easy”, but it frequently is fun, exciting, and allows one to become stimulated in ways that many work activities cannot. Additionally, while not "easy", there are things one should be mindful of when taking on entrepreneurial endeavors which provide much greater likelihood of success. Among them is an awareness of various methods, conceptual approaches, and theories that have been applied to much effectiveness. This week’s Tip utilizes an example from another country; specifically, the prospect of pharmacist prescribing in Canada. Certain provinces allow for pharmacist prescribing there, yet its uptake is not always what was envisioned. Diffusion on Innovation Theory might provide some insight.

Guirguis et al implemented a tool to help discern the extent to which pharmacists take up prescribing in Alberta.¹ They found 8 to facilitate the pharmacist’s uptake: (1) self-efficacy (eg, confidence in ability to prescribe and initiate new therapy); (2) support from the practice environment (eg, adequate staffing, access to patient information, employer expectations; (3) support from interprofessional relationships (eg, sense of collaboration with other prescribers);  (4) impact on professionalism (eg, how this is perceived to look for pharmacists, or the extent that it advances the profession); (5) impact on patient care (eg, whether the patient is better off with pharmacists able to prescribe); (6) prescribing beliefs (eg, whether the role extends what pharmacists already do, and possible increased liability for pharmacists; (7) technical use of the electronic health record (EHR) (eg, whether the health record is easily accessible and navigable); and (8) patient care use of the EHR (eg, the extent to which the EHR has the necessary lab values, medication history, and other requisite information).

The above results were from a study that employed Diffusion of Innovations Theory to guide the study in identifying those factors responsible for pharmacist uptake of prescribing. Organizational culture and support, adequate training to ensure self-efficacy, investing in capacity, and giving persons the tools they needed were instrumental. The same can be said for most processes and innovations. Pharmacy managers must provide a supportive environment and consistently “walk the walk”; that is, if the manager comes up with new ideas yet doesn’t follow through or give employees the tools they need, those employees will begin to view these ideas in a negative light. Instilling the right culture of support will help to promote entrepreneurial ideas and build cadres of the willing in joining you.

Additional information about Entrepreneurship and Innovation and Organizational Structure and Behavior can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Guirguis LM, Hughes CA, Makowsky MJ, et al. Development and validation of a survey instrument to measure factors that influence pharmacist adoption of prescribing in Alberta, Canada. Pharm Pract (Granada) 2018;16:1068.