Agility: An asset for pharmacies undergoing transformation

Over the past 10 years, Canadian community pharmacy practice has evolved at an exhilarating, if sometimes bewildering, pace. A key driver of this transformation is the long-overdue recognition from government bodies and the general public that pharmacists play a vital role in front-line health care.

Having graduated from the Université de Montréal Faculty of Pharmacy in 2007, I am now seeing the practice of my peers moving toward what I was taught and what I hoped to achieve with patients at the start of my career as a pharmacist.

Of course, these new responsibilities are placing ever-increasing demands on pharmacies and their managers, and adapting to this new reality is an imposing challenge. Firstly, pharmacists generally receive limited training in operations management and innovation. Secondly, lab teams must maintain their day-to-day operations while juggling new responsibilities that require a reorganization of resources and processes. And on top of that, teams need to prepare for the future!

Having worked in software development for 15 years, I've recently come to realize that community pharmacy labs operate increasingly like the tech industry, which is characterized by high volatility and rapid transformation. Yet, it seems that very few of the management principles commonly used in the technology sector are currently applied in pharmacy.

I was eager to imagine how certain agile practices, translated to the context of a pharmacy laboratory, could support pharmacist-owners, managers, and their teams in the challenges they face. At Vigilance Santé, we benefit from the expertise of an Agile Practice Leader within our Operations Support team. It's in collaboration with François Beaulieu that I took part in this exercise!

What is agility?

As markets and practices continue to evolve, we must continuously adapt to new realities. The principles of agility provide us with some of the tools we need to prepare and accustom ourselves to the constant changes that characterize our environment.

Agility is:

Our ability to continuously adapt by integrating new knowledge.

As a result, we place a premium on flexibility and adaptation, taking progressive steps that we test to gain insights and adjusting accordingly. This approach is particularly appropriate at a time of rapid technological change, where requirements and expectations can change overnight. You could say that we aim to transform uncertainty and change into genuine opportunities for growth and innovation.

My years of experience have shown me that collaboration is crucial to agility. Meaningful exchange between collaborators and transparency are the foundational pillars of an efficient and sustainable practice, as they help to increase our effectiveness as a team. That's why we need to create opportunities for collaboration.

So, to sum up, there are three points to remember:

1. Iterations: taking progressive action
2. Inspection: conducting retrospectives
3. Collaboration: fostering productive interactions

Agility at Vigilance Santé

Agility has been an integral part of Vigilance Santé's culture for many years. It serves us well in terms of business decisions, but also in the way we organize our day-to-day work. Since 2018, we have had multidisciplinary teams in place, made up of experts in pharmacy and software development. This combination of knowledge, experience, and expertise enables us to design innovative, high-quality products that meet the needs of health care professionals.

Collaboration and iterations

Collaboration is critical to our agility. We create opportunities for exchange by holding team meetings during which employees can share their ideas and set short-term objectives. During brainstorming sessions, we work together to come up with the most promising hypotheses and identify the new features that would be the most valuable to those who use them.

We divide these new features into smaller increments that can be developed over two-week work periods ("sprints"). Every day, we hold a 15-minute daily scrum to discuss our progress, next steps, and potential obstacles.

At the end of each sprint, we conduct a retrospective where we analyze the results, identify opportunities for improvement, and define the objectives for the next iteration. These practices promote continuous improvement.

Workflows

To efficiently track our work, we use a digital tool inspired by a whiteboard and sticky notes, with columns for each step of our workflow. Here's an example of a simple workflow:

1. To do. Tasks that are ready to start.
2. In progress. Active tasks.
3. To verify. Pending reviews or tests.
4. Done. Completed tasks.

Each task is represented by a sticky note with information such as the task owner and potential obstacles. The board is continuously updated to ensure transparency within the team.

How does this translate to pharmacies?

We wondered how agile working methods could be used in a community pharmacy. While some of the challenges faced by pharmacies are similar to those in the software development industry, we're well aware that community pharmacy has its own particular set of circumstances.

As mentioned earlier, these three important concepts can serve as a starting point for initiating change:

• Iterations
• Retrospectives
• Collaboration

Iterations

Firstly, agile work methods call for frequent small increments, rather than occasional major changes. In practical terms, this means progressively integrating changes to operations or introducing new activities gradually, in small "chunks" over the course of a predetermined period, or sprint.

For example, to integrate new clinical activities, a pharmacy might proceed as follows:

• Start by choosing a few targeted services as the first increment.
• Offer these services to a limited number of patients, managed by selected team members.
• Then, every month, introduce one to two additional services.
• Eventually, every team member will be able to provide the full range of services.

In some cases, it can be very helpful to add a preparatory iteration. What tasks need to be done to maximize your chances of success and achieve your goals? All you have to do is make a list of the team's tasks and make sure it's visible to everyone. Once again, a bulletin board or whiteboard can be a simple and very effective tool!

Retrospectives

Iterations are only effective if they are paired with retrospectives. These allow the team to review what they've accomplished and ask questions like: "What went well, and why?" "What challenges did we encounter?" "What can we put in place to improve our performance during the next sprint?"

This stage is vital for highlighting success factors and identifying adjustments that will lead to improvements. Based on this information, the team can then determine what would be realistic and logical to include in the next sprint. For this reflection process to be truly useful, the group needs to be humble, transparent, and willing to improve.

Collaboration

Most of the pharmacists we spoke to preparation for this article felt that communication within the laboratory team is challenging and often limited to day-to-day operations or procedural changes. How can you foster proactive communication and effective collaboration when the waiting room is full from morning to night, and the full lab staff is never on site at the same time? There are a few simple ways to get around these constraints, such as using a collaborative whiteboard (physical or digital) and scheduling regular team meetings at the end/beginning of periods.. Since effective collaboration requires input from the whole team, it's important to set aside time for it and value everyone's opinions and ideas.

As part of the agile approach, one team member is designated to support continuous improvement processes and oversee the initiative. A similar role could be very useful in a pharmacy laboratory. The purpose of this new role is to support implementation and ensure communication between different shifts throughout the month.

Modifying the way you manage change is definitely a challenge!

But imagine the return on investment if these simple actions not only optimized laboratory operations, but also enabled your pharmacy to integrate new services. And that's not all: Think of the motivation and engagement that everyone on your team will feel by being actively involved and heard in this process.

So, what are you waiting for? What will you do first after reading this article? You could start with something as simple as talking about it with a colleague or a team member. Remember: Small iterations lead to the biggest changes! 🚀