EO 002.02 Addressing Technical Pharmacy Questions (Dari)

1. EO 002.02 Addressing Technical Pharmacy Questions(Dari) 01/09/2013

2. Importance of Lesson(Dari) • Insert Dari • In the prior lectures you learned the aspects of effective communication. This involved actively listening to an individual, understanding their message and responding appropriately. • During daily Pharmacy activities many interactions with patients or other healthcare providers involve the need to solve a problem. AFAMS

3. Importance of Lesson(Dari) • Insert Dari • Effective listening is essential for problem solving. • Though Pharm Techs are not able to respond to clinical questions they are able to respond to non-clinical questions. • The purpose of the following lecture is to teach you problem solving techniques and where to find the necessary pharmacy information. AFAMS

4. Overview EO 002.02(Dari) • Problem solving steps • Open and closed questions • Technical vs Clinical question • Pharmacy references • Lesson Review • Scenarios (not graded) • Insert Dari AFAMS

5. Problem SolvingDari “Everybody can benefit from having good problem solving skills as we all encounter problems on a daily basis; some of these problems are obviously more severe or complex than others.”www.skillsyouneed.com • Insert Dari AFAMS

6. Problem SolvingDari What is a Problem? “A doubtful or difficult matter requiring a solution” and “Something hard to understand or accomplish or deal with.” Concise Oxford Dictionary www.skillsyouneed.com • Insert Dari AFAMS

7. Problem SolvingDari All problems have two features in common: goals and barriers. Goals • To achieve some objective or desired state of affairs and can include avoiding a situation or event. • E.g If you are hungry then your goal is probably to eat something. www.skillsyouneed.com • Insert Dari AFAMS

8. Problem SolvingDari All problems have two features in common: goals and barriers. Barriers • If there were no barriers in the way of achieving a goal, then there would be no problem. • Problem solving involves overcoming the barriers or obstacles that prevent the immediate achievement of goals. • E.g. If you feel hungry then your goal is to eat. A barrier to this may be that you have no food available - you take a trip to the store and buy some food, removing the barrier and thus solving the problem. www.skillsyouneed.com • Insert Dari AFAMS

9. Stages of Problem SolvingDari Stages of Problem Solving: • Problem Identification • Structuring the Problem • Looking for Possible Solutions • Making a Decision • Implementation • Monitoring/Seeking Feedback www.skillsyouneed.com • Insert Dari AFAMS

10. Problem IdentificationDari Stage One: Identifying the Problem • Before being able to confront a problem its existence needs to be identified. • This might seem an obvious statement but, quite often, problems will have an impact for some time before they are recognized or brought to the attention of someone who can do anything about them. • Once a problem has been identified, its exact nature needs to be determined: what are the goal and barrier components of the problem? www.skillsyouneed.com • Insert Dari AFAMS

11. Problem IdentificationDari Stage One: Identifying the Problem Examples Goal:I want to tell a friend that we find something they do irritating. Barrier:But, I don't want to hurt their feelings. Goal: I want to tell buy a new computer. Barrier:But, I'm not sure which model to get or how much money is reasonable to spend. • Looking at the problem in terms of goals and barriers can offer an effective way of defining many problems and splitting bigger problems into more manageable sub-problems.www.skillsyouneed.com • Insert Dari AFAMS

12. Problem IdentificationDari Stage One: Identifying the Problem Problem: “I have been offered a job that I want, but I don't have the transport to get there and I don't have enough money to buy a car.” Break into sub problems: Main Problem: “I want to take a job”Sub-problem 1: “But I don't have transport to get there” Sub-problem 2: “And I don't have enough money to buy a car” www.skillsyouneed.com • Insert Dari AFAMS

13. Identifying the ProblemDari Stage One: Identifying the Problem During this first stage of problem solving, it is important to get an initial working definition of the problem.Problem: “I have been offered a job that I want, but I don't have the transport to get there and I don't have enough money to buy a car.” Working definition: “I want to take this job.” • a good working definition makes it possible to describe the problem to others who may become involved in the problem solving process. www.skillsyouneed.com • Insert Dari AFAMS

14. Stage Two: Structuring the ProblemDari The second stage of the problem solving process involves gaining a deeper understanding of the problem. Firstly, facts need to be checked. Problem: “I want to take a job, but I don’t have the transport to get there and I don’t have enough money to buy a car.”Checking Facts: “Do I really want a job?”“Do I really have no access to transport?”“Can I really not afford to buy a car?”www.skillsyouneed .com • Insert Dari AFAMS

15. Stage Two: Structuring the ProblemDari • The questions have to be asked, is the stated goal the real goal? • Are the barriers actual barriers and what other barriers are there? Goal: “Take the job”Barrier #1: “No transport” Barrier #2: “No Money” This is also a good opportunity to look at the relationships between the key elements of the problem. For example, there are strong connections between all the elements. • By looking at all the relationships between the key elements, it appears that the problem is more about how to achieve any one of three things, i.e. job, transport or money, because solving one of these sub-problems will, in turn, solve the others. www.skillsyouneed .com • Insert Dari AFAMS

16. Stage Two: Structuring the ProblemDari By looking at all the relationships between the key elements, it appears that the problem is more about how to achieve any one of three things, i.e. job, transport or money, because solving one of these sub-problems will, in turn, solve the others. Goal: “Take the job”Barrier #1: “No transport” Barrier #2: “No Money” www.skillsyouneed .com • Insert Dari AFAMS

17. Stage Two: Structuring the ProblemDari By writing out a problem you can see the relationship between sub-problems and barriers. Problems can be represented in the following ways: • Visually: using pictures, models or diagrams. • Verbally: describing the problem in words. Visual and verbal representations include: • Chain diagrams • Flow charts • Tree diagrams • Lists www.skillsyouneed .com • Insert Dari AFAMS

18. Chain DiagramsDari • Chain diagrams are powerful and simple ways of representing problems using a combination of diagrams and words. The elements of the problem are set out in words, usually placed in boxes, and positioned in different places on a sheet of paper, using lines to represent the relationship between them. www.skillsyouneed .com • Insert Dari AFAMS

19. Flow ChartsDari • Flow charts allow for inclusion of branches, folds, loops, decision points and many other relationships between the elements. • They can be quite complicated and there are many conventions as to how they are drawn but, generally, simple diagrams are easier to understand and aid in 'seeing' the problem more readily. www.skillsyouneed.com • Insert Dari AFAMS

20. Simple Flow Chart: AFAMS

21. More Complex Flow Chart AFAMS

22. Tree DiagramsDari • Tree diagrams and their close relative, the Decision Tree, are ways of representing situations where: • there are a number of choices • different possible events to be considered • useful for considering all the possible consequences of solutions. www.skillsyouneed.com • Insert Dari AFAMS

23. Tree DiagramsDari • Insert Dari AFAMS

24. ListingDari Listing the elements of a problem can also help to: • represent priorities • order and sequence the problem • goals can be listed in order of importance • place barriers in order of difficulty. • list barriers in the order in which they need to be solved.www.skillsyouneed.com • Insert Dari AFAMS

25. ListingDari • Insert Dari AFAMS

26. Stage Three: Possible Solutions Dari In group situations this involves finding ways to actively involve everybody - encouraging participation and generating as many ideas and possible solutions as possible.www.skillsyouneed.com • Insert Dari AFAMS

27. Stage Three: Possible Solutions Dari Brainstorming is perhaps one of the most commonly used techniques for generating a large number of ideas in a short period of time. • It can be done individually, or in groups.www.skillsyouneed.com • Insert Dari AFAMS

28. Brainstorming RulesDari The Instructor will explain the purpose of the brainstorming session (on next slide) The four rules of brainstorming that must be adhered to: • Absolutely no criticism of suggestion or person is allowed. • The aim is to produce as many ideas as possible. • The aim is to generate a sense of creative momentum. All ideas should be encouraged, regardless of how irrelevant, 'stupid' or 'off the mark' they might seem. • Everyone should continually look at the suggestions of the rest of the group and see if these spark any new ideas.www.skillsyouneed.com • Insert Dari AFAMS

29. Brainstorming ExerciseDari Problem: The school is planning to have a sports afternoon next week. The sport to be played needs to be chosen. Brainstorm possible sports to be played. • Instructor to write student responses on the board. • At the end of the session, give time to reflect on and to discuss the suggestions and to clarify some of the ideas.www.skillsyouneed.com • Insert Dari AFAMS

30. Step Four: Making a DecisionDari • Once a number of possible solutions have been arrived at, they should be taken forward through the decision making process. • Many different techniques of decision making have been developed, ranging from simple rules of thumb, to extremely complex procedures. • The method used depends on the nature of the decision to be made and how complex it is. • e.g Decisions to provide a medication is based on a policy. (simple) • A person not entitled to medications will die without them. Decision to provide based on ethics and values (more complex)www.skillsyouneed.com • Insert Dari AFAMS

31. Step Four: Making a DecisionDari The stages are: • Listing all possible solutions/options. • Brainstorming • Setting a time scale and deciding who is responsible for the decision. • Determining who is responsible (next slide) • How much time is available to spend on this decision? • Is there a deadline for making a decision and what are the consequences of missing this deadline? • Is there an advantage in making a quick decision? • How important is it to make a decision? • How important is it that the decision is right? • Will spending more time improve the quality of the decision?www.skillsyouneed.com • Insert Dari AFAMS

32. Responsibility for a DecisionDari Before making a decision, it needs to be clear who is going to take responsibility for the decision. • It is not always those making the decision who have to assume responsibility for it. • Is it an individual, a group or an organisation? • At work consider the structure of the organisation. • Who has to carry out the course of action decided? Finally, you need to know who can actually make the decision? • The Chief of Pharmacy has authority to make decisions other Pharmacists do not. www.skillsyouneed.com • Insert Dari AFAMS

33. Step Four: Making a DecisionDari The stages (Continued): • Listing all possible solutions/options. • Setting a time scale and deciding who is responsible for the decision. • Information gathering. • Weighing up the risks involved. • Deciding on values, or in other words what is important. • Weighing up the pros and cons of each course of action. • Making the decision. www.skillsyouneed.com • Insert Dari AFAMS

34. Information Gathering • Insert Dari • All relevant information needs to be gathered. • If there is inadequate or out-dated information then it is more likely that a wrong decision might be made. (e.g. what is the goal; are there new policies) • A lot of irrelevant information will make a decision difficult to make due to distraction. • The amount of time spent on information gathering has to be weighed against how much you are willing to risk making the wrong decision. • www.skillsyouneed.com

35. Weighing the RisksDari One key question is how much risk should be taken in making the decision? • Generally, the amount of risk an individual is willing to take depends on: • The seriousness of the consequences of taking the wrong decision. • The benefits of making the right decision. • Not only how bad the worst outcome might be, but also how likely that outcome is to happen. • It is also useful to consider what the risk of the worst possible outcome occurring might be, and to decide if the risk is acceptable. • Commit to the complete solution or just an acceptable solution if risk to great. (e.g. opting for medication over surgery) www.skillsyouneed.com • Insert Dari AFAMS

36. Deciding on ValuesDari Deciding on Values • Everybody has their own unique set of values - what they believe to be important. • Many people decide to buy a car for themselves but different people buy different cars based on their own personal values. • Price • Speed • Performance. • Others might value safety, luggage space. www.skillsyouneed.com • Insert Dari AFAMS

37. Deciding on ValuesDari Deciding on Values Continued: • People do not make decisions based on just one of their values. • They will consider all their values which are relevant to the decision and prioritize them in order of importance. www.skillsyouneed.com • Insert Dari AFAMS

38. Class ExerciseDari Directions: • Each student is to write down the five most important factors to them when buying a car. • Once all students have written down their five factors (values) the instructor will pick five students to read their five factors aloud to the class. • Were all factors (values) for the five students the same? Was the priority of factors different between students?www.skillsyouneed.com • Insert Dari AFAMS

39. Deciding on ValuesDari Deciding on Values Continued: • Depending on which values are considered important, different opinions may seem more or less attractive. • If the responsibility for a decision is shared it is possible that one person might not have the same values as the others. • Therefore, consensus is required. • Ie. vote www.skillsyouneed.com • Insert Dari AFAMS

40. Class ExerciseDari Directions: • Each student is to write down the five most important factors to them when buying a car. • Once all students have written down their five factors (values) the instructor will pick five students to read their five factors aloud to the class. • Were all factors (values) for the five students the same? Was the priority of factors different between students?www.skillsyouneed.com • Insert Dari AFAMS

41. Pros and ConsDari Weighing up the Pros and Cons • It is possible to evaluate the pros and cons of each possible solution/option by considering the possible advantages and disadvantages. • List the advantages and disadvantages of each solution. www.skillsyouneed.com • Insert Dari AFAMS

42. Make the DecisionDari Does any con go against your values? • List the pros and cons. • If the pros outweigh the cons then: • Implement the solution with the most pros. • Implement only part of the solution. • If cons outweigh pros then: • Look at other solutions. • Implement only part of the solution that removes the cons. Intuitive Judgements can be used to make decisions: • Many influences, which have not been considered, may play a part. • prejudice • wishful thinking • reliance on past experience without consideration of past mistakes. www.skillsyouneed.com • Insert Dari AFAMS

43. Make the DecisionDari • Making a decision using intuition alone should be an option and not done merely because it is the easy way out, or other methods are more difficult. • Intuition is a perfectly acceptable means of making a decision, although it is generally more appropriate when the decision is of a simple nature or needs to be made quickly. • E.g. Filling your gas tank on the way to work or wait until after. • As a Pharm Tech answering a Physician question if a medication is on the ANA Formulary. • More complicated decisions tend to require a more formal, structured approach. • E.g. Whether or not to add a medication to the ANA Formulary (Pharmacy and Therapeutics Committee) • Decisions can be made via an intuitive or reasoned process, or a combination of the two. www.skillsyouneed.com • Insert Dari AFAMS

44. Stages of Problem Solving Cont’dDari Stages of Problem Solving: • Problem Identification • Structuring the Problem • Looking for Possible Solutions • Making a Decision • Implementation • Monitoring/Seeking Feedback www.skillsyouneed.com • Insert Dari AFAMS

45. ImplementationDari Implementation involves: • Being committed to a solution. • Accepting responsibility for the decision. • Identifying who will implement the solution. • Resolving to carry out the chosen solution. • Exploring the best possible means of implementing the solution. www.skillsyouneed.com • Insert Dari AFAMS

46. Stages of Problem Solving Cont’dDari Stages of Problem Solving: • Problem Identification • Structuring the Problem • Looking for Possible Solutions • Making a Decision • Implementation • Monitoring/Seeking Feedback www.skillsyouneed.com • Insert Dari AFAMS

47. Monitoring and Seeking FeedbackDari • The only way for an individual or group to improve their problem solving, is to look at how they have solved problems in the past. • To do this, feedback is needed and, therefore, it is important to keep a record of problem solving, the solutions arrived at and the outcomes. Ways of obtaining feedback include: • Monitoring (for decisions that will be require to be repeated over and over) • Questionnaires (complicated decisions) • Follow-up phone calls (complicated decisions) • Asking others who may have been affected by your decisions. • (e.g Ask the patient or Physician if you answered their question or met their needs) www.skillsyouneed.com • Insert Dari AFAMS

48. Conclusions to Problem SolvingDari • Problem solving involves: • seeking to achieve goals and overcoming barriers. • The stages of problem solving include: • Problem Identification • Structuring the Problem • Looking for Possible Solutions • Making a Decision • Implementation • Monitoring/Seeking Feedback www.skillsyouneed.com

49. Questions?

50. Overview EO 002.02(Dari) • Problem solving steps • Open and closed questions • Technical vs Clinical question • Pharmacy references • Lesson Review • Scenarios (not graded) • Insert Dari AFAMS