A theoretically informed interview study of strategic stakeholders on their readiness to implement a pharmacist competency framework for hospital practice

Introduction Introducing a pharmacist competency framework into a healthcare system has the potential to improve patient care but also poses several challenges. Assessing the readiness of all healthcare stakeholders in position of policy influence is an essential step to identify the correct implementation approach. In Austria, efforts to implement a competency framework for hospital pharmacists are ongoing, yet empirical evidence on the readiness of key healthcare stakeholders remains limited. Aim The aim of this study was to explore the readiness of key healthcare policy stakeholders on the possible implementation of a hospital pharmacist competency framework into Austrian hospital practice. Method A qualitative interview study underpinned by the Consolidated Framework for Implementation Research (CFIR) with 20 key healthcare policy stakeholders was conducted across Austria. A topic guide and additional study material were developed based on the CFIR. Interview questions were validated and piloted. Interviews were audio-recorded, transcribed ad verbatim and coded in accordance with the CFIR by two researchers independently. Transcripts were analysed using thematic analysis until saturation of themes. Results Facilitators and barriers emerged across all five CFIR domains. Key facilitators were aspects of innovation, inner setting and implementation (e.g., relief for physicians due to reducing their workload, teamwork and communication to support implementation, etc.) while key barriers were also related to inner and outer setting, as well as the implementation, specifically the need for adequate structural and financial resources and a sensitive implementation process to not interrupt well-established workflow processes. Conclusion This theory-informed study has highlighted the positive attitudes of participants stating their general readiness for implementation. Careful implementation will be necessary not to overwhelm the healthcare system by a sudden change in working structures, processes and hierarchy. These results have impacted policy and educational change for hospital pharmacists across Austria.