What does CSHP do?
Right now, CSHP has just finished a four-year cycle for their strategic business plan (although this is more of a strategic plan in general - it has less to do with business). Our current mission is to be the national voice of hospital pharmacists (etc etc) and to be honest, I have forgotten our vision. In regards to advocacy, CSHP runs a national campaign once annually, and this year it was to advocate for recognition and enabling of pharmacist prescribing in the hospital pharmacy setting. CSHP also liaises with (very) many external organizations, either on specific initiatives (the ADAPT initiative, the Blueprint for Pharmacy, Pharmacist Awareness Week) or to keep in touch with what other organizations are doing, how that is relevant to hospital pharmacy, and communicate it to our members and/or work with those organizations to make their initiatives more relevant and engaging for hospital pharmacists.
CSHP also runs two conferences a year, SES and PPC, which are educational in nature but also serve as face-to-face executive and Council meeting venues. CSHP also offers many membership services, which I'll define in a broad umbrella. CSHP writes "official publications" which help guide hospital pharmacists in regards to fundamental, high-level concepts relevant in hospital pharmacy; other official publications help elucidate CSHP's position on perhaps a controversial topic facing hospital pharmacy. CSHP hosts the Pharmacy Specialty Networks (PSN's), which are basically email lists/groups where pharmacists who share an interest or specialty can discuss specific questions with pharmacists across the country. CSHP also is the home of the CHPRB (Canadian Hospital Pharmacy Residency Board); hence the requirement that all Canadian-accredited pharmacy residents join CSHP. And finally, CSHP hosts the operational side of the CJHP (Canadian Journal of Hospital Pharmacy); the CJHP editorial board (of which Dr. Mary Ensom is the lead editor) functions independently.
There are some other things CSHP does. CSHP has a Fellows program which designates excellent hospital pharmacists with the "FCSHP" title. CSHP also has a (separate) R&E (research and education) Foundation, a charitable organization which funds research and education in hospital pharmacy.
So what sorts of things have I been personally involved in? It's all over the place really, and because my internship is shortened (8 weeks, but the equivalent of 2 weeks is spent outside the office due to visitations and the SES conference), things have been flying around very quickly. To pick a place to start: I sat in a CJHP editorial board meeting with Colleen, who supervises the Publications. The board basically went through all the articles and their various stages of review and acceptance statuses. It was impressive how systematic it was; most of the discussion per se centred around editorial topics (the editors take turns writing and requesting people write a Pro or Con piece as part of the Point Counterpoint column). For the CJHP, I have recently been surfing the internet for resources to combat article plagiarism. While it doesn't look like there are any free trials, I hadn't known up to this point how big of a problem this was. Obviously, journals want to publish original content. Taylor & Francis found that 3 science journals that tried CrossCheck, an anti-plagiarism program, and had had trouble in the past with plagiarism reported rejecting 23%, 10% and 6% of submitted articles. So far, most of the journals I have contacted with similar scope as CJHP have not implemented such resources, but they are all interested.
Another item I was working on was collating publishing, cost, and open access policies for journals commonly used by hospital pharmacists. The CJHP has recommended to the CSHP Council that it move towards online-only access and free open access. CSHP's concern is in regards to decreased advertising revenue and the loss of the CJHP as a membership benefit. Myrella, the CSHP Executive Director and my boss, asked me to take a snapshot of what other journals were doing; it was a very interesting exercise. Recently, NIH has mandated that all peer-reviewed articles derived from research funded by an NIH grant have the post-review manuscript posted on the PubMed Central public repository, at the latest by 12 months post-publication. CIHR has done something similar, although it is less iron-clad.(1) I did not realize that there would be so many headaches with this. The funding agencies want the authors to retain copyright of their articles and to ensure that these articles become open access as described in the policies. However, the journals in which these articles are published and which are responsible for peer-review are usually not comfortable with just giving up the copyright. Most journals only allow the post-review manuscript (so not the final, published version, although the content should be the same) to be deposited in the repository. Also, errors in the article identified later may not be quickly fixed in the repository version, while journals are well-equipped to handle such developments. And finally, there are revenue concerns. Some journals push for an embargo period such that the author may not allow their repository article to be accessible until 6 or 12 months (whatever they can get away with), even though according to the NIH policy, it is the author who should be able to choose that timeframe. Other journals have started charging APCs (article processing charges, or a fee upon article submission); and still other journals have started charging "optional" APCs for authors who are required (or feel compelled) to abide by their funding agency's open access policy. So this will bring a lot of discussion to the CJHP in regards to how it wants to structure its open access, authorship policy, and subscriptions, and it is tough for them because most of the authors who publish in the CJHP are not 'funded' per se for the work.
Next up is the CSHP Official Publications. These encompass the guidelines, statements, standards, and information papers. They are "official," vetted documents that CSHP produces, through a structured process of volunteer leads, staff development and copy-editing, member feedback, and Council approval. They are not "clinical guidelines" in that they do not recommend that post-MI patients get beta-blockers; rather, they are guidelines and other documents that discuss general concepts relevant to hospital pharmacy, such as pharmaceutical care, research, formulary and inventory concepts, and compounding standards. Thus, the average hospital pharmacist will not find them as useful as a pharmacy manager or a pharmacist who is trying to start a new initiative or evaluate a pharmacy-related process will. There have been some concerns that CSHP is too "reactive," in that we address things that are brought to our attention or things that ASHP (American Society of Health-System Pharmacists) have done a few years ago; however, we are much smaller of an organization and the scope and efficiency with which we can accomplish these documents of significance is limited by our resources.
Over my time with CSHP I have become very familiar with the Official Publications. I have been crossmapping them with the FIP Basel Statements, which are a series of consensus statements established by a FIP (International Pharmacy Federation) meeting regarding best hospital pharmacy practices. The intent here is to see whether our Official Publications align with such an important document. My own observation is that in many respects, Canadian (and American) pharmacy practice is "ahead of the game" compared to pharmacy worldwide. According to Cathy, the Membership and Professional Affairs Coordinator, European hospital pharmacists are very much focused on their distributive role - they take great pride and effort into insuring the accuracy of dispensed drug products (procurement, labelling, compounding, administration) but the concepts of "pharmaceutical care" and collaborative prescribing are not entrenched. Hence, the Basel Statements have not been fully aligning with the CSHP OPs (we have significantly less detail with administration and procurement topics, and significantly more when it comes to taking responsibility for patient outcomes and how to further professional education and development). In addition to the crossmapping, I have also been reviewing a few draft OPs (or OPs that are in need of revision), which can be a painstakingly tedious process. One of these was regarding Research, and it was useful to me as I am planning a Directed Studies project / protocol for myself in the fall.
The next major topic is the Blueprint for Pharmacy, which is primarily a CPhA initiative but is in principle a collaboration between all the major pharmacy-related organizations in Canada (eg. the teleconference I attended had BCPhA represented as well). The Blueprint started with a Vision for Pharmacy which is a straightforward document that sets forward 5 strategic directions. Over the last year or so they have added several documents, including an Implementation Plan for how to achieve those strategic directions that sets goals and objectives, and a self-assessment tool to see where your own practice can improve. The current status is using the Implementation Plan to identify projects that would meet key objectives and seek funding for them. In my opinion, this has been a somewhat slow process, but perhaps necessarily slow as it represents all the member organizations and the Blueprint office needs to assimilate all the feedback it receives. The Blueprint is still very poor, and is in need of a few flagship projects that will achieve some of the identified objectives and that will qualify for funding. During my short time listening in on the Blueprint workings, I found that it was very important that CSHP (and by corollary, the other external organizations) be actively involved in the project. Pharmacy is such a diverse profession, and there are many different interests and different perspectives that matter when you are trying to move forward with a single plan and just a few projects. Notably, hospital pharmacists make up 20% of all pharmacists in Canada, and so CSHP's voice is particularly needed to advocate for practice changes that will benefit hospital pharmacists (as in several respects, community pharmacy is just trying to "catch up" to hospital pharmacy).
Coincidentally, I was speaking with someone who mentioned that BC's eHR (electronic health record) initiative is currently dead in the water (although that is an exaggeration). From what I understand, the responsible person for PharmaNet II has quit. To me, this is extremely disappointing. I can't emphasize enough how important it is to have a reliable, user-friendly, capable, efficient, and uniform IT health care system across the province that is accessible to multiple health disciplines and that will contribute to safe and effective health care (beyond the scope of pharmacist-provided medication management). IT is out of scope for most pharmacists that I know, and it is disappointing that the concept of eHealth has been around for so long, but that it has not been developed and implemented yet, despite government funding.
To talk about soon:
-adapt
-membership and SES prep
-strategic planning
References: (1) CIHR Policy on Access to Research Outputs. Policy Summary. Updated 2010 Apr. 29. Available from: http://www.cihr.ca/e/32005.html.
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