Board Highlights - November 15, 2019

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Board Highlights - November 15, 2019

Topics include initial Continuing Education audits, pharmacy prescribing authority update, PODSA modernization phase II bylaw amendments and Professional Practice Policies, pharmacists' injecting authority update and more. 

You can re-watch all the Board meeting presentations through the College’s Periscope Channel.

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Welcome and Swearing in of New Board Members

The College of Pharmacists of British Columbia is pleased to welcome four newly elected representatives to its Board.

Board members, whether pharmacists, pharmacy technicians or public appointees, bring diverse points of view to the table and work as a team to make sound policy and governance decisions in the public interest.

The College’s 2019 Board Elections took place earlier this year in District 1 (Metropolitan Vancouver), District 3 (Vancouver Island/Coastal), District 5 (Northern BC), and District 7 (Community Hospitals).

The successful candidates (listed below), were sworn in at this month’s meeting.

Learn more about each candidate by clicking his/her name.

Alex Dar Santos, District 1 (Metropolitan Vancouver)

Andrea Silver, District 3 (Vancouver Island/Coastal)

Michael Ortynsky, District 5 (Northern BC)

Claire Ishoy, District 7 (Community Hospitals)

The College would like to thank all the pharmacists and pharmacy technicians who took the time to help select the best representatives from each district to join the College Board.

Board Chair and Vice-Chair Election Results

The College Board elections for Chair and Vice-Chair took place at the November meeting.

Chair: Christine Antler, District 2 - Fraser Valley representative, was elected Board Chair

Vice-Chair: Anca Cvaci, District 6 - Urban Hospitals representative, was elected Vice-Chair

Appointment of Board Members to Committees

The Board approved a number of new appointments to certain College committees. 

College committees are a vital resource to the Board that provide essential advice, expertise, and recommendations that ultimately help inform Board decisions. 

The Governance Committee has reviewed the current roster of committee members, and is proposing certain changes to committee membership.  The proposed changes are due in part to the Board election in November 2019, and the expiry of the terms of certain government appointed Board members, which result in significant changes to Board composition. 

Application Committee

  • Appoint John Beever as Chair
  • Appoint Derek Lee as Vice-Chair
  • Appoint Katie Skelton as member
  • Remove Christine Antler as Chair (will remain as member)
  • Remove Justin Thind as member

Audit and Finance Committee

  • Appoint Steven Hopp as Chair
  • Appoint Alex Dar Santos as Vice-Chair and member
  • Appoint Anca Cvaci as Member
  • Remove Tracey Hagkull as Vice-Chair (will remain as member)
  • Remove Frank Lucarelli as Chair and member

Governance Committee

  • Appoint Anne Peterson as Chair
  • Appoint Claire Ishoy as Vice-Chair and member
  • Appoint Anca Cvaci as a member
  • Appoint Katie Skelton as member
  • Remove Mona Kwong as Chair and member
  • Remove Tara as Vice-Chair and member
  • Remove Christine Antler as member

Jurisprudence Examination Subcommittee

  • Appoint Bal Dhillon as Chair
  • Remove Tara Oxford as Chair (will remain as member)

Legislation Review Committee

  • Appointed Justin Thind as Chair 
  • Appointed Andrea Silver as Vice-Chair and member
  • Appointed Claire Ishoy as member
  • Removed Mona Kwong as Chair and member

Pharmacy Advisory Committee

  • Appointed Anca Cvaci as Chair 
  • Appointed Andrea Silver as Vice-Chair and member 
  • Removed Tara Oxford as Chair (will remain as member)

Past Chairs Advisory Committee

  • Appoint Mona Kwong as Chair and member
  • Appoint Anar Dossa as member
  • Appoint Blake Reynolds as member

Quality Assurance Committee

  • Appoint Michael Ortynsky as Chair and member
  • Remove Frank Lucarelli as Chair (will remain as member)
Quality Assurance Committee: Initial CE Audit Findings

Frank Lucarelli, Chair of the Quality Assurance Committee (QAC), presented the Board with the QAC’s initial Continuing Education (CE) audit findings.

As part of the Quality Assurance Program, set out in the College’s Health Professions Act Bylaws, continuing education is an important requirement to ensure all pharmacy professionals continue to provide safe and effective care.  As a result, CE audits also play an important role in ensuring registrants are successfully completing continuing education and identifying opportunities to improve the Professional Development and Assessment. 

The QAC establishes the processes for monitoring and auditing CE submissions. All CE submissions are automatically verified for completeness by the PDAP Portal. Those selected for CE Audits are manually verified for compliance. 

As part of developing the CE Audit approach strategy, the College received recommendations from a statistician regarding the CE Audit criteria, including the number of pharmacy professionals to audit each year, selection process and what to include in the audit (e.g.. the type of learning).

The initial CE Audit cycle started in September 2018 and ended in August 2019 (1 full year). It consisted of pharmacy professionals randomly selected from the 2017 and 2018 renewal deadline year as well as those in the Reinstatement (returning to practice) category. A total of 400 pharmacy professionals and 2224 Learning Records were audited.

Aggregate results from the initial audit will be used to identify areas for improvement in the audit process, website content and other registrant communication and materials including the PDAP Portal Tutorial and Learning Record Examples. Individual results will be followed up with for clarification if needed. 

CPBC’s Journey to Excellence​

Catherine Neville, Vice President and Lead Client Strategist for Excellence Canada, presented to the Board the College’s journey toward achieving a Silver Certification under Excellence Canada’s Excellence, Innovation and Wellness (EIW) Standard.

An exceptional amount of hard work and dedication is required to become a recipient of the standard. Meeting the standard involved a comprehensive assessment of the College as an organization from all perspectives, including its employees, customers, leadership, governance, planning, processes, social responsibility, suppliers, partners and results. This work is also reflected within the College’s 2017/18 – 2019/20 Strategic Plan, which places particular focus on the theme of Organizational Excellence.

The 5 Drivers of the Excellence, Innovation and Wellness Standard are:

  • Leadership
  • Planning
  • Customers
  • People
  • Process and Project Management

In May 2019, the College was officially awarded the EIW Silver Certification by Excellence Canada’s Verification Team.

Achieving Excellence Canada’s Silver Certification will ensure the College of Pharmacists of British Columbia’s status as a modern, relevant and progressive organization, able to continue to fulfill its mandate of better health through excellence in pharmacy within an ever-changing provincial health landscape.

Pharmaceutical Delivery by Drone

Chris Chiew, General Manager of Pharmacy for London Drugs, presented to the Board on the use of drone delivery to provide easier access to medications for Canadians who live in remote areas.

On August 19, 2019, London Drugs, in partnership with Canada Post and InDro Robotics, successfully flew pharmaceuticals by drone from Vancouver Island to multiple locations on Salt Spring Island, as part of a test program. Providing healthcare to Canadians living in remote areas that are not serviced in a consistent and timely manner provides a number of challenges. As such, the use of available and emerging technologies present viable alternatives to healthcare providers.

This test marked the first time medication has been delivered beyond visual line of sight (BVLOS) by drone in Canada.

Invisible Barriers: 2SLGBTQ+ People and Healthcare

Bex Peterson, nonbinary writer, student, and advocate for 2SLGBTQ+ peoples, presented to the Board guidance and best practices for addressing healthcare challenges faced by the 2SLGBTQ+ community.

Members of the 2SLGBTQ+ community face specific health care challenges, especially with regards to mental health. Often the people most in need of care can find themselves alienated by a medical system that is still in the process of expanding and redefining “normal.” Healthcare practitioners can bridge these gaps through empathy, education, and small actions to signal a welcoming environment for people of all genders and sexualities. By healing an individual with care and compassion, we can start to heal a community.

Pharmacist Prescribing Authority Update

Christine Antler, Board Chair, provided the Board with an update on the Framework for Pharmacist Prescribing in BC. 

The Framework for Pharmacist Prescribing in BC has been a multi-year project which aims to help protect patient safety and improve patient outcomes. Reduced risk factors for chronic disease, improved blood glucose, improved blood pressure, improved lipid levels, and reduced risk for major cardiovascular events are all examples of pharmacist prescribing in collaborative relationships preventing harm and improving patient outcomes in recent studies.

In November 2015, a draft framework was presented to the Board and approved, in principle, for stakeholder engagement. Initially, stakeholder groups were divided in their level of confidence in pharmacists prescribing as well as their support for the initiative. The feedback received indicated overwhelming support from pharmacists and pharmacy technicians, but strong resistance from other prescribers. The public feedback was divided. 

After reviewing the results of the engagement, the College Board directed the Registrar to amend the initial draft framework by narrowing the scope of pharmacist prescribing to within collaborative practice. As a result, a revised Framework for Pharmacist Prescribing in BC was developed and a second round of consultations was conducted. The feedback received during the second round of consultations demonstrated increased confidence in pharmacist prescribing from all stakeholder groups. 
 
In November 2017, the final Framework for Pharmacist Prescribing in BC and the Engagement Report was presented to and approved by the Board.

A proposal was submitted to the Minister of Health in September 2018 and resubmitted in November 2018 requesting amendments to the Pharmacists Regulation under the Health Professions Act.Learn more about this initiative at bcpharmacists.org/prescribing. 

PODSA Modernization Bylaw Amendments

The Board approved amendments to Pharmacy Operations and Drug Scheduling Act (“PODSA”) Bylaws, as part of the Legislative Standards & Modernization Goal within the College’s 2017/18 – 2019/20 Strategic Plan.

In accordance with its Strategic Plan, the College conducted a comprehensive review and reform of legislative requirements under PODSA, including the bylaws and policies made under that Act. This PODSA Modernization Project is split into two phases. Phase One involved amendments to the PODSA Bylaws relating to pharmacy ownership requirements which came into effect on April 1, 2018. 

Phase Two involves a review of legislation and policies to ensure the following:

  • Bylaws are clearer and duplication in bylaws and policies is addressed,
  • Professional Practice Policies (“PPP”) are standardized and transitioned to bylaw where needed, and
  • Bylaws and PPPs have consistent writing style and structure.

The following key bylaw topics are addressed in the Phase Two PODSA Bylaw amendments:

  • Operation of a community pharmacy without a full pharmacist,
  • Responsibilities of managers, direct owners, directors, officers and shareholders,
  • Storage of drugs and confidential health information, including offsite storage,
  • Developing provisions to allow for community telepharmacy reinstatement,
  • Bylaws that are not being complied with based on data from the Practice Review Program,
  • Reviewing PharmaNet requirements in light of the transition of administration of PharmaNet functions to the Ministry of Health, and
  • House-keeping amendments, including ensuring consistency of writing style.

At their June 2019 meeting, the Board approved the public posting of the proposed bylaws for a 90-day period. Based on the feedback received, and further review by College staff minor amendments have been made to the proposed bylaws related to:

  • Clarifying requirements for suspended pharmacies,
  • Removal of depot delivery provision, 
  • Re-wording of provisions for clarity,
  • Consistent use of pharmacy name on signage, labels, and directory listings, and
  • Minor house-keeping amendments.

The approved amendments will now be sent to be filed with the Ministry of Health and will come into effect 60 days from the date they are sent. Stay tuned for more information.

PODSA Modernization Phase II Professional Practice Policies

The Board also approved changes to a number of the College’s Profession Practice Policies (PPPs) to be effective at the same time that the previously mentioned PODSA Modernization Phase Two Bylaw Amendments come into force.

These changes include: 

Repealing PPP-25 Disaster Preparedness

  • The intent of this policy will instead be reflected through College Bylaws as part of the PODSA Modernization approved amendments and through amendments to other related policies (such as PPP-31 Emergency Prescription Refills).
  • The College is also working on developing guidance related to emergency preparedness and will be updating the resource page at bcpharmacists.org/emergency.

Approving amendments to the following PPPs: 

  • PPP-31 Emergency Prescription Refills
    • The proposed amendments stem from the proposed repealing of PPP-25. Provisions relevant to providing an emergency supply of drugs in PPP-25 were appended to PPP-31, where appropriate.
    • To align with the PODSA Bylaws related to this policy, the title of the policy was updated to “PPP-31 Emergency Supply for Continuity of Care”.
  • PPP-46 Temporary Pharmacy Closures
    • Key provisions within PPP-46, related to temporary pharmacy closures, were transitioned into the amended bylaws for anticipated temporary closures for no more than 14 consecutive days and for unanticipated pharmacy closures no longer than 90 days. As such, the proposed amendments to this policy set out additional notification procedures for both anticipated and unanticipated pharmacy closures.
  • PPP-54 Identifying Patients for PharmaNet Purposes
    • The proposed amendments to this policy were made to clarify that PPP-54 applies not only to patients, but patient’s representatives as well, in both community pharmacy and telepharmacy settings.
    • To reflect these amendments, the title of the policy was updated to “PPP-54 Identifying Patients and Patient Representatives in Community and Telepharmacy Settings”.
  • PPP-59 Pharmacy Equipment
    • Proposed amendments to this policy were made to modernize pharmacy equipment requirements based on current technologies available and to ensure the requirements are in line with what is necessary to ensure patient safety.
  • PPP-65 Narcotic Counts and Reconciliations
    • Proposed amendments to this policy were made to align with Health Canada’s updated policy on loss or theft reporting, and guidance document on inventory reconciliation.
    • Additionally, changes were made to improve clarity on existing PPP-65 requirements, consistency with proposed PODSA Bylaws amendments, and alignment with modern pharmacy practices.
  • PPP-73 Validate Identification and College Registration Status for New Pharmacy Hires
    • Proposed amendments to this policy include clarifying that confirmation of an employee’s identity and registration status are to be done at the start of employment, but not during the application process. Stemming from the amended bylaws, which require pharmacy managers to ensure all individuals working in the pharmacy who represent themselves as registrants are registered with the College, a provision was added to the policy, which requires pharmacy managers to confirm the registration status of all staff registrants from time to time, at least annually. To align with this provision, the title of the policy  was updated to “PPP-73 Validate Identification and Verify College Registration Status for New and Existing Registrant Staff”.

Approving consequential amendments to the following PPPs:

Drug Administration Committee – Pharmacists’ Injection Authority Update

Bob Nakagawa, Registrar and CEO, provided the Board with an update from the first meeting of the Safe Drug Administration by Pharmacists Working Group, which occurred on October 28, 2019.

In February 2019, based on recommendations from the Drug Administration Committee (DAC), the Board directed the Registrar to remove the current restrictions on pharmacists’ authority to administer drugs by injection and the intranasal route, while restricting the administration of injections for cosmetic purposes and retaining current age limit restrictions.

The College was invited to work with the Professional Regulation and Oversight Branch of the Ministry of Health to establish a working group to determine the impacts of removing these restrictions on other health profession regulators, interprofessional practice and patient care.

Members of the working group include College staff, a member of the DAC, and representatives from:

  • Ministry of Health 
  • British Columbia College of Nursing Professionals 
  • College of Dental Surgeons of British Columbia
  • College of Naturopathic Physicians of British Columbia
  • College of Physicians and Surgeons of British Columbia
  • College of Podiatric Surgeons of British Columbia
  • College of Optometrists of British Columbia

During the meeting, the working group discussed:

  • Defining the need for removal of restrictions on pharmacist injection authority using the principles of Right-touch regulation;
  • Outlining the impacts of removing the current restrictions on pharmacist drug administration authority including defining the specific drugs or drug classes which would be included or excluded from the authority;
  • Determining the potential impacts on the broader healthcare system (including health professional regulatory colleges and the Ministry of Health); and 
  • Considering existing drug administration issues that could be potentially addressed by pharmacists in the future, including expanding pharmacist administration to include intravenous infusions.

The working group is expected to reconvene in early 2020 to continue to discuss these items. The working group will provide its findings on the impacts of removing the restrictions on pharmacists’ authority to administer medications by injection and the intranasal route  to the College’s DAC and the Ministry of Health.

Our Commitment to Improve Cultural Safety and Humility for First Nations and Aboriginal Peoples

The College’s Director of Communications and Engagement, Gillian Vrooman provided the Board with an update on the ongoing work surrounding the College’s commitment to improve cultural safety and humility for First Nations and Aboriginal Peoples.

On March 1, 2017, the College’s Registrar, Bob Nakagawa, pledged the College’s commitment to improving BC pharmacy professionals’ work with First Nations by signing the “Declaration of Cultural Safety and Humility in Health Services Delivery for First Nations and Aboriginal Peoples in BC”

By signing the Declaration of Commitment, the College has committed to actions and processes, which will ultimately embed culturally safe practices within health professional regulation.

The College developed a strategy to fulfill its commitment presented the strategy to the College Board in September 2017. Since then, the College has made significant progress in operationalizing this strategy.

Some of the key initiatives implemented in the past two years include:

Public Acknowledgements of Our Commitment to Cultural Safety and Humility

The College has updated its processes to recognize the indigenous lands on which it is situated through a land acknowledgement and has incorporated a statement on its commitment to cultural safety and humility into all public reports and presentations.

College Board Cultural Safety and Humility Resource

The College provides a Cultural Safety and Humility Resource for its Board Members to ensure they have the information, tools and training available to understand the College’s commitment and learn about cultural safety and humility, reconciliation and the health inequalities of First Nations and Aboriginal Peoples.

Cultural Humility and Safety Resource Page

The College has a dedicated resource page on cultural safety and humility which has information about the College’s commitment and strategy in addition to opportunities to learn more about cultural safety and humility.

Cultural Humility and Safety ReadLinks Series

In 2018, the College established a Cultural Humility and Safety ReadLinks Series to help pharmacy professionals learn about the culture and experiences of First Nations and Aboriginal Peoples in BC, the importance of acknowledging racism in healthcare, and the role of cultural humility and safety in providing care.

First Nations Health Authority Mental Health and Wellness Summits

The College was fortunate to be a part of the 2018 and the 2019 Mental Health and Wellness Summits hosted by the First Nations Health Authority.

The College connected with local public health directors and administrators, mental health professionals, and community leaders. The conversations were focused on what the College, as one of BC’s largest health professions, can do to advance cultural safety and humility for First Nations and Aboriginal Peoples within BC’s public health system. 

Gathering Wisdom for a Shared Journey IX

The College was honored to join the BC Health Regulators Information Booth at the Gathering Wisdom IX forum in 2018.

The College engaged in conversations on what health professionals can do in their practice to improve cultural safety and humility for First Nations and Aboriginal Peoples within BC’s public health system. Over 80 participants shared their thoughts and ideas.

BC Women’s Indigenous Day of Wellness Event

In 2018 the College also participated in the BC Women’s Indigenous Day of Wellness event in Vancouver, BC as part of celebrating National Indigenous Peoples Day.

The College used its booth at BC Women’s Indigenous Day of Wellness event to share information on its role in protecting patient safety and its plan to improve cultural safety and humility.

The College also engaged in conversations on what pharmacy professionals can do in their practice to improve cultural safety and humility for First Nations and Aboriginal Peoples.

National Indigenous History Month

June is National Indigenous History Month and the College used this time to remind registrants and College staff to take a moment to reflect on, recognize and celebrate the unique heritage, diverse cultures and outstanding contributions to Canadian society of First Nations, Inuit and Metis peoples. 

RECAP OF THE BOARD MEETING ON SOCIAL MEDIA