The scope of clinical pharmacy services in Singapore has increased tremendously in recent years. Ensuring that clinical pharmacists have the adequate training and mentorship to enable them to perform these extended roles in a competent fashion is crucial in providing safe and effective patient care.
Singapore Health Services, known as SingHealth, is the largest healthcare group in Singapore, offering a complete range of multidisciplinary and integrated medical care through a network of three hospitals, five national specialty centres and nine polyclinics (1).
In 2007 the Singapore General Hospital (SGH), a member of the SingHealth group, started A collaboration with CoDEG to adapt the GLF for use in a Singapore context. In May 2009, the SGH version of the GLF was rolled out for SGH’s 30 inpatient junior pharmacists. In August 2009, the roll out was extended to 18 outpatient junior pharmacists.
Recent developments have also seen the Singapore Ministry of Health (MOH) endorse the use of the competency frameworks as part of the new national career pathway for pharmacists in Singapore. This is an exciting development, which puts SingHealth's competency training initiatives at the forefront of the development of the pharmacy profession in Singapore.
The key to any successful competency training programme is for the trainers and users to understand the concepts and processes. With this in mind, Professor Ian Bates, Dr Catherine Duggan, and Jurate Svarcaite from CoDEG joined forces in Singapore with Dr Ian Coombes and Lynda Cardiff from the Medication Services Queensland, Queensland Health, Australia to conduct a five-day GLF training programme in December 2009.
On the first day of the program, all SingHealth pharmacists were invited to an engagement dinner with the Assistant Chief Executive Officer (ACEO) to find out more about how the new career structures and competency frameworks being implemented across SingHealth would benefit them. The ACEO and representatives from SingHealth human resources met with the CoDEG team and officially exchanged a Memorandum of Understanding, a milestone in the continued collaboration between SingHealth and CoDEG.
The GLF Workshop was led by Dr Ian Coombes. The SGH experience of implementing the GLF and ACLF was shared by Dr Camilla Wong, Chairperson of the SingHealth Pharmacy Clinical Specialist and Research Track Workgroup. Audiences were also told how the findings from the GLF baseline and four month assessment, together with the GLF survey had helped in identifying gaps for fine-tuning of pharmacists' education and training.
One-to-one intensive ‘train the trainers’ sessions on the practical application of the GLF were conducted for 16 'super users', carefully selected from seven SingHealth institutions (SGH, CGH, KKH, NHC, NCC, SNEC and SHP). These 'super users' are expected to take the lead in the training of other GLF leaders in their own institutions. CoDEG also provided an opportunity to utilize the eGLF for the first time since its development.
The five-day program was concluded with a round table sharing of experiences related to the GLF from CoDEG, Queensland and SingHealth, leading to many constructive suggestions for future roll-out within SingHealth institutions. A major breakthrough among pharmacy leaders was also reached at this point with the decision to adopt a unified ‘SingHealth’ GLF tool. To close the programme, CoDEG were invited to meet and discuss the role of the ACLF for specialists' accreditation with the MOH Pharmacy Specialists - Board Pro Tem Committee.
Why use the GLF in Singapore?
The GLF is a developmental tool that encompasses the holistic scope of pharmacy practice: namely knowledge, skills and attitudes. Ultimately, the aim is to produce competent pharmacists who provide safe and effective healthcare practice to the nation. Strategically aligned with Singapore’s National Patient Safety Goals (2), the use of the GLF is destined to win the support of all stakeholders. In addition, by developing the more junior pharmacists through the GLF, the senior pharmacists are also developing themselves. This is reflected in the ACLF, e.g. under education/training and leadership.
Factors affecting job satisfaction such as responsibility, impact on patient care and professional development are strongly correlated with regular use of developmental tools such as the GLF and the miniCEX. The tools can be used to highlight previously 'hidden' areas of performance, and can identify specific elements of practice for positive reinforcement as well as raising individualised areas for development in a professional manner. Our experience among the 16 ‘super users’ during the five-day programme has reinforced these aspects.
SingHealth would like to take this opportunity to thank CoDEG and their colleagues from SMPU Queensland Health for their time and expertise that they have invested in this collaboration and for their ongoing help and support.
2. Singapore’s National Patient Safety Goals
·Singapore General Hospital (SGH)
·Changi General Hospital (CGH)
·Kandang Kerbau Women’s and Children’s Hospital (KKH)
·National Heart Center Singapore (NHC)
·National Cancer Center Singapore (NCC)
·Singapore National Eye Center (SNEC)
·National Dental Center (NDC)
·National Neuroscience Institute (NNI)
·SingHealth Polyclinic (SHP)
We are dedicated to meeting the needs of:
Goal 1 Identify patients correctly
Goal 1 Identify patients correctly
Goal 2 Improve effective communication
Goal 3 Improve safety of high alert medications
Goal 4 Ensure correct site, correct side, correct patient surgery
Goal 5 Comply with hand hygiene guidelines
Goal 6 Reduce the risk of patient harm resulting from falls
An expert group of critical care pharmacists have produced guidance for pharmacists wishing to specialise in the area of adult critical care. Click here for more information.
For information on the development of the General Level Framework in Australia click here.
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