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Evaluation and Credentialing of Advanced Practice Pharmacists

First Round Consultation

May 2014

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Consultation paper

1. BackgroundIn Australia, the ageing population has impacted on the health related services provided by

healthcare professions. Increasing age brings with it an increase in the number of co‐existing disease

states, and a resultant increase in therapeutic intervention and complexity. For pharmacists, these

changes provide both challenges and opportunities for the individual practitioner and the

profession. The practice of pharmacy has also evolved with time. A shift in focus from the supply of

medicines to a greater level of patient‐centred input has been observed. Along with these changes,

pharmacists have begun to position themselves as experts in medicines.

Recognition of practice improvement, and in particular the achievement of advanced skills and

knowledge, provides the profession with an opportunity to define the specific requirements of

advanced practice and the process for assessment of these requirements. The outcome of this

process is an improved structure within the profession and the provision of clear direction for the

individual practitioner.

1.1 Development of the Advanced Pharmacy Practice Framework (APPF)

The desirability of undertaking work directed at gaining recognition for advanced pharmacy practice

in Australia was identified during the review of the Competency Standards in 2010. At that time, the

Advanced Pharmacy Practice Framework Steering Committee (APPFSC) was formed with nominees

from each of the following organisations:

Australian Association of Consultant Pharmacy (AACP)

Australian College of Pharmacy (ACP)

Australian Pharmacy Council (APC)

Council of Pharmacy Schools: Australia and New Zealand

Pharmaceutical Defence Limited (PDL)

Pharmaceutical Society of Australia (PSA)

Pharmacy Board of Australia

Professional Pharmacists Australia (PPA)

Pharmacy Guild of Australia

Society of Hospital Pharmacists of Australia (SHPA).

On behalf of the pharmacy profession in Australia, the APPFSC developed the Advanced Pharmacy

Practice Framework (APPF). It was endorsed by the Council/Board of the respective organisations

involved in the steering committee in October 2012.

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The APPF has not been developed in isolation. The APPFSC has recognised and built upon work

undertaken by numerous pharmacists across Australia, including SHPA Committees of Specialty

Practice, and Cancer and Oncology Services of Australia (COSA).1

Evidence and validity has been incorporated from the Advanced and Consultant Level Framework

(ACLF) developed by the UK Competency Development and Evaluation Group (CoDEG) and Royal

Pharmaceutical Society of Great Britain. The original ACLF was developed by the CoDEG in 2004.

Since then, the ACLF has been extensively validated across pharmacy in the UK, at all levels of

practice, and principally in hospital, community and primary care sectors, and updated in 2013 by

the Royal Pharmaceutical Society.2

The APPF has been developed to ensure applicability across sectors, specialities and for both roles

involved with the provision of direct clinical care and those without. The APPF is available to all

practitioners wanting to advance their practice in all sectors.

1.2 Objectives of the APPF

The objectives of developing an Advanced Pharmacy Practice Framework were to:3

advance the capabilities of the profession;

identify and recognise excellence in professional practice;

create opportunities for pharmacists; and

prepare the profession for future change.

The intention is to support the process of professional development by defining expectations of

pharmacists at different levels of practice.

The APPF has been designed to be sufficiently flexible to serve as a template for describing advanced

practice expectations in all areas of professional practice where it may be considered desirable to

recognise advanced pharmacy practice. More detail about the background to developing the APPF

can be found in the document An Advanced Pharmacy Practice Framework for Australia at

www.advancedpharmacypractice.com.au

1.3 Application of the APPF

The APPF allows pharmacists to self‐assess and identify what stage they currently practice at within

each of the ‘cluster areas’.

Pharmacists can start with considering their role and experiences and how they might map to the

clusters in the framework, alongside the evidence they have to support a cluster. Alongside that,

examples of development from practice often map against more than one cluster and across many

competencies.

1 Advanced and Extended Pharmacy Practice: An environmental snapshot. Canberra: Australian Pharmacy Council; 2013. At: http://pharmacycouncil.org.au/content/index.php?id=32 2 The RPS Advanced Pharmacy Framework. Royal Pharmaceutical Society; 2013. At http://www.rpharms.com/faculty‐documents/rps‐advanced‐pharmacy‐framework‐guide.pdf 3 Background. In: An Advanced Pharmacy Practice Framework for Australia; October 2012.

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Pharmacists can use the framework to identify areas they want to develop further across all areas of

practice, not just expertise or to progress to a higher level. For pharmacists this is a very useful tool

to target CPD and to populate a Professional Development Plan (PDP).

1.4 Who is the APPF for?

The Advanced Pharmacy Framework applies to all pharmacy professionals; the application of, and

opportunity to demonstrate, the competencies in the APPF will differ according to the career stage

of the pharmacy professional and the type of role they fulfil. The context in which competence can

be achieved will become more complex throughout the stages as well as more demanding with

career progression.

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2. Developing a Process for Formal RecognitionThe primary purpose of the APPF is ‘to support and assist the professional development and growth

of pharmacists (regardless of whether their scope of practice is broad or narrow) and of the

profession as a whole’,4 to optimise health outcomes for consumers.

During profession wide consultation following the release of the APPF, members of the profession

and the organisations represented on the APPFSC indicated that there needs to be a means by which

the public can be confident that pharmacists who call themselves ‘advanced’ have been assessed as

such through a single, nationally consistent and credible process.

The APPFSC also investigated, discussed and agreed on several aspects of the model for advanced

pharmacy practice recognition in Australia which balances rigour with the ability to implement such

a model.

Concurrently, the APC commissioned a project to inform the development of a contemporary and

sustainable pathway for recognition of pharmacy practitioners in extended and advanced practice

roles. The broad aims of the project were to review the methods employed by health care

professions to recognise advanced and extended practice both in Australia and internationally, and

to consider the factors which may impact on the recognition of advanced and extended practice in

the Australian context. The report was published in September 2013.5

In December 2013, the APC was endorsed by the organisations that represent the pharmacy

profession in Australia as the independent assessment entity being responsible and accountable for

the credentialing of advanced practitioners.

4 Advanced Pharmacy Practice Framework Steering Committee. An Advanced Pharmacy Practice Framework for Australia. October 2012. 5 Advanced and Extended Pharmacy Practice: An environmental snapshot. Canberra: Australian Pharmacy Council; 2013. At: http://pharmacycouncil.org.au/content/index.php?id=32

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2.1 Development timelines

The development of the evaluation standards, policies and procedures for the credentialing of

advanced practice pharmacists is to be conducted over the course of 2014, with piloting of the

credentialing process to be commenced at the end of the year.

March 2014 Seek expressions of interest for Advanced Practice Credentialing Committee

April 2014 Select members of Credentialing Committee

May 2014 First meeting of Credentialing Committee

May – June 2014 First round consultation:

Release of first draft credential evaluation standards, policies and processes and public comment invited

June – August 2014 Feedback reviewed and incorporated

August 2014 Second round consultation:

Release of second draft credential evaluation standards, policies and processes and public comment invited

Release of draft pilot evaluation approach and key stakeholder comment invited

September – October 2014

Approval of credential evaluation standards, policies and processes by APC for public release

December 2014 – January 2015

Credential evaluation standards, policies and processes applied in pilot

January – March 2015 Pilot feedback received, collated, analysed and reported

April – June 2015 Feedback reviewed and incorporated

Credentialing process open to all pharmacists

Every effort will be made to meet the timeline described. However, the conduct of the pilot is also

dependent on the development of an online platform for portfolio preparation and submission,

which will be informed by these evaluation standards, policies and procedures.

As a quality outcome is the higher priority, timelines may change in order to adequately address the

feedback received throughout the consultation process in relation to the evaluation standards,

policies and procedures. Stakeholders will be kept informed if there are significant changes to this

timeline.

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2.2 Development and consultation process

The following are the underlying processes to be used in the development of the evaluation

standards, policies and procedures for the credentialing of advanced practice pharmacists:

Transparent process for development

Use of a response template – provides a common framework and assists in feedback

aggregation

Use of an online survey at the following URL:

https://australianpharmacycouncil.wufoo.eu/forms/advanced‐practice‐public‐consultation‐

may‐2014/

Collation and consideration of responses

Acknowledgement of contributors and respondents – where agreed by contributors,

submissions will be made public on the APC website.

2.3 Principles underpinning the proposed credentialing process

The following principles underpin the proposed credentialing process for advanced practice

pharmacists in Australia:

Principle 1. Recognition of advanced practice is conducted with the objective of enhancing

the capacity of pharmacists to contribute to health care.

Principle 2. The credentialing of advanced practice pharmacists will support consumer

participation in health.

Principle 3. Practitioner development is a key element of achieving practice at an advanced

level, with support and recognition required along the continuum.

Principle 4. Advanced practice is credentialed through a single, uniform and independent

assessment process.

Principle 5. The processes for credentialing are fair, transparent and robust.

Principle 6. Only those who have been externally evaluated and credentialed may use the

title Advanced Practice Pharmacist.

In developing the first draft of the evaluation standards, policies and processes for the credentialing

of Advanced Practice Pharmacists, it was agreed by the APPFSC that a practice portfolio could be

used for collecting evidence of a pharmacist’s development and would serve as the basis for

evaluating a pharmacist for credentialing. It was agreed that the portfolio:

Would allow pharmacists to be free to choose their own pathway for building advanced level

competence

Would require sufficient evidence in all component areas, i.e. depth of practice, professional

standing, specialty knowledge and performance

Could be built by pharmacists themselves or by seeking guidance through a readiness

support organisation

https://australianpharmacycouncil.wufoo.eu/forms/advanced-practice-public-consultation-may-2014/

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Would require performance at an advanced level to be demonstrated for at least 70% of the

criteria within as well as across the domains in the Advanced Pharmacy Practice Framework

Would allow competence for scope of practice to be demonstrated through a self‐

assessment and the recency of practice declarations associated with pharmacist registration

Would be evaluated by a panel of three members with at least one pharmacist and at least

one interdisciplinary member; panel members would be selected to ensure relevant subject

matter expertise, current practice experience and assessment knowledge and experience.

It has also been discussed that:

The process for building a portfolio should be straightforward for pharmacists to understand

and follow.

The evaluation process should be a criterion‐based assessment (and not a norm‐referenced

or competitive form of assessment)

The evaluation process should adhere to the principles of assessment, being:

o Valid – where the process gathers sufficient evidence to cover the required aspects

of the standards being evaluated.

o Reliable – where the process is consistent and accurate such that it is able to be

used in different contexts and at different times, and still return the same outcome

regardless of the evaluator making the decision.

o Flexible – where the process allows for reasonable adjustments to cater for

individual pharmacists, while still remaining valid.

o Fair – where the process does not discriminate against particular pharmacists.

The process should be manageable and support timely evaluation.

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3. First Round Consultation Questions To support structured feedback from stakeholders and members of the pharmacy profession, the

following questions are used to prompt feedback.

1. Standards for evaluation

[Refer to Attachment 2 DRAFT Standards for the evaluation and credentialing of advanced

practice pharmacists]

Are the Standards for the evaluation and credentialing of advanced practice pharmacists

consistent with the expectations expressed in the Advanced Pharmacy Practice Framework

(APPF)? If not, what requires amendment and why?

2. Clarity of process

[Refer to Sections 5.1 and 6 in the document Evaluation and credentialing of advanced


a. Is there sufficient clarity around area of practice versus scope of practice? If not,

what requires amendment and why?

b. Is there sufficient guidance on defining your scope of practice? If not, what requires

amendment and why?

c. Is there sufficient clarity around scope of practice versus area of expert professional

practice? If not, what requires amendment and why?

d. Is the process sufficiently clear for individual pharmacists to follow in preparing an

application? If not, what requires amendment and why?

3. Breadth of evidence

[Refer to Section 6.6 in the document Evaluation and credentialing of advanced practice

pharmacists]

Do the example evidence sources provide sufficient guidance as to the breadth of sources

that could be considered and the flexibility allowed in developing a portfolio? If not, what

requires amendment and why?

4. Rules of evidence


pharmacists]

Are the explanations of what constitutes valid, authentic, current and sufficient evidence

clear? If not, what requires amendment and why?

5. Evaluator panel

[Refer to Sections 7.1, 7.2 and 7.3 in the document Evaluation and credentialing of advanced


Is the process by which evaluator panel members are identified, trained and selected

sufficient for ensuring a valid and reliable assessment process? If not, what requires

amendment and why?

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6. Principles of assessment

[Refer to Sections 5.2 and 7 in the document Evaluation and credentialing of advanced


Do you have any further comments or recommendations in relation to the evaluation

process and its adherence to the principles of assessment (i.e. that it is valid, reliable,

flexible and fair)?

7. Feedback

[Refer to Attachment 1 Performance criteria for advanced pharmacy practice and Section 7.6

in the document Evaluation and credentialing of advanced practice pharmacists]

a. Do pharmacists expect to be told whether they are at Transition, Consolidation or

Advanced level when receiving feedback following evaluation of their portfolio?

b. Is there value in feedback being provided in the form of a professional development

plan?

8. Credential titles


pharmacists]

What title should be awarded to pharmacists who meet the Standards for the evaluation

and credentialing of advanced practice pharmacists?

9. Credential periods and re‐credentialing


pharmacists]

Is the time period for which a credential awarded appropriate? If not, for what duration

should it be awarded and why? What level of evidence should be provided for ongoing

credentialing?

10. To what extent do you agree the following features are important in the process for

recognising advanced pharmacy practice in Australia?

[Likert scale – Strongly disagree, Disagree, Neutral, Agree, Strongly agree]

Validity of the evaluation process

Reliability of the evaluation process

Flexibility in the evaluation process

Simple portfolio preparation process

Minimal cost to the pharmacist

Consumer understanding of what the credential means

Credibility of the credential within the pharmacy profession

Credibility of the credential within the health sector

International recognition

11. General feedback

Please provide any other feedback.

EvaluationandcredentialingofadvancedpracticepharmacistsDRAFTv1.0

This draft has been prepared by the Australian Pharmacy Council for First Round Public Consultation

with key stakeholders.

21 May2014

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Contents1. Introduction to advanced practice ................................................................................................. 2

1.1 Advanced practice: why do we need it? ................................................................................. 2

1.2 The Advanced Pharmacy Practice Framework: what is it? ..................................................... 2

1.3 Areas and scopes of practice for which advanced practice can be achieved ......................... 3

1.4 Pathways for achieving an advanced level of practice ........................................................... 4

2. Guiding principles for the credentialing of advanced practice pharmacists in Australia ............... 6

3. Roles and responsibilities associated with advanced practice recognition .................................... 8

3.1 Overview of roles and responsibilities .................................................................................... 8

4. Governance for advanced practice credentialing ........................................................................... 9

4.1 Overview ................................................................................................................................. 9

4.2 Australian Pharmacy Council .................................................................................................. 9

4.3 Advanced Practice Credentialing Committee ....................................................................... 10

4.4 Credential Evaluator Panel .................................................................................................... 10

4.5 Overarching policies .............................................................................................................. 11

5. Overview of the portfolio development and evaluation process ................................................. 12

5.1 Building a portfolio ................................................................................................................ 12

5.2 Portfolio evaluation .............................................................................................................. 13

5.3 The APC online Pharmacist Practice Portfolio ...................................................................... 14

6. Portfolio preparation .................................................................................................................... 15

6.1 Describing area of practice ................................................................................................... 15

6.2 Defining scope of practice .................................................................................................... 15

6.3 Self‐assessment of competence ........................................................................................... 15

6.4 Describing area of Expert Professional Practice ................................................................... 15

6.5 Advanced level performance ................................................................................................ 15

6.6 Gathering evidence of performance ..................................................................................... 16

6.7 Pre‐check against credentialing requirements ..................................................................... 20

6.8 Fees associated with evaluation and credentialing .............................................................. 20

7. Portfolio evaluation ...................................................................................................................... 21

7.1 Evaluator Panel member competencies ............................................................................... 21

7.2 Evaluator Panel member training ......................................................................................... 23

7.3 Selection process for a specific Evaluator Panel ................................................................... 23

7.4 Evaluation of portfolio .......................................................................................................... 24

7.5 Moderation of reports and feedback to pharmacist ............................................................ 24

7.6 Award of credential ............................................................................................................... 24

8. Glossary ......................................................................................................................................... 25

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1. Introductiontoadvancedpractice

1.1 Advanced practice: why do we need it?

From a patient’s perspective, the competence of healthcare professionals should be assured,

regardless of whether a recent graduate or mature professional. Delivery of a competent and

capable workforce requires clear articulation of expectations coupled with an effective process for

ensuring these are consistently met. Expectations should be reflective of current practice, based on

accepted standards and partnered with quality education and training.

Professional practice is dynamic. Evolution of practice may be influenced by external factors such as

changes in the population to which services are provided, and internal factors specific to the

profession, such as those observed when the profession accepts an additional role or begins to

provide existing services in a new and novel way.

A fundamental premise of effective healthcare is the provision of services that meet the needs of the

public. When these needs change, appropriate modification to the type and manner in which

healthcare services are delivered is required.

In Australia, the ageing population has impacted on the health related services provided by

healthcare professions. Increasing age brings with it an increase in the number of co‐existing and

chronic disease states, and a resultant increase in therapeutic intervention and complexity. For

pharmacists, these changes combined with aged care policy changes provide both challenges and

opportunities for the individual practitioner and the profession.

The practice of pharmacy has also evolved with time. A shift in focus from the supply of medicines to

a greater level of patient‐centred input has been observed. Along with this change, pharmacists have

begun to position themselves as experts in medicines.

Recognition of practice improvement, and in particular the achievement of advanced skills and

knowledge, provides the profession with an opportunity to define the specific requirements of

advanced practice and the process for assessment of these requirements. The outcome of this

process is an improved structure within the profession and the provision of clear direction for the

development of the individual practitioner.

1.2 The Advanced Pharmacy Practice Framework: what is it?

Broad competencies attributed to performance at an advanced level are articulated in the Advanced

Pharmacy Practice Framework (APPF). This framework is intended to support the process of

professional development by defining expectations of pharmacists at different levels of practice. The

framework recognises that many characteristics of advanced practice are common across practice

areas. It is intended the framework be flexible and applicable to all sectors of the profession.

Individual areas of practice may seek to customise the framework and articulate the specific skills

and knowledge required for competent practice in that setting. It is essential that modifications are

made in accordance with clear standards and processes.

The APPF identifies five key areas (which may be referred to as ‘competency clusters’) that are

important for development in and demonstration of advanced levels of practice.

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The competency clusters are grouped within two overarching areas:

Area 1: Expert professional practice

As reflected by a pharmacist’s area and scope of practice

Area 2: Networking, leadership and influence

Professional and ethical practice

Communication, collaboration and teamwork

Leadership and management

Critical analysis, research and education

The APPF comprises 30 competencies located across the five clusters; each competency is described

at three stages of performance development: Transition, Consolidation and Advanced level.

Advanced practice is ‘practice that is so significantly different from that achieved at initial

registration that it warrants recognition by professional peers and the public of the expertise of the

practitioner and the education, training and experience from which that capability was derived’.1

1.3 Areas and scopes of practice for which advanced practice can be achieved

Pharmacists are health professionals who possess a unique and complex body of knowledge and

skills which they apply on behalf of other members of the community to optimise health outcomes

from medicines.2 The areas in which a pharmacist practises are not limited to the provision of direct

clinical care; pharmacists may also work in non‐clinical relationships with consumers, management,

administration, education, research, advisory, regulatory or policy development roles.3

For those providing direct clinical care, the areas in which a pharmacist practises can be broad,

covering a wide variety of consumers and a broad range of medical conditions (e.g. community

pharmacist). Alternatively, they can be narrow, covering a broad range of medical conditions in a

specific consumer group (e.g. paediatrics or geriatrics) or directed to a limited range of medical

conditions across a wide variety of consumers. (e.g. diabetes or cardiovascular). Similar observations

could be made when describing the area of practice for pharmacists in any role.

A pharmacist’s scope of practice is defined by the activities that the individual pharmacist is

educated, competent and authorised to perform, and for which they are accountable. It is a time‐

sensitive and dynamic aspect of practice. A pharmacist’s scope of practice can be defined through

the Domains of the Competency Standards.4

Advanced practice can be achieved for any scope of practice. It is the level of performance within

that scope of practice that will determine whether advanced practice has been achieved (see Figure

1).

1 Advanced Pharmacy Practice Framework Steering Committee. An Advanced Pharmacy Practice Framework for Australia. October 2012. 2 National Competency Standards Framework for Pharmacists in Australia. Canberra: Pharmaceutical Society of Australia; 2010. 3 Pharmacy Board of Australia. Professional indemnity insurance arrangements standard. Available at www.pharmacyboard.gov.au. 4 National Competency Standards Framework for Pharmacists in Australia. Canberra: Pharmaceutical Society of Australia; 2010

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Figure 1. Using scope of practice

and performance to define practice

type5

1.4 Pathways for achieving an advanced level of practice

There are an infinite number of pathways towards achieving advanced level performance. After

registering as a pharmacist, it is expected that an individual’s career will continue to develop in

various ways, e.g. with respect to experiential background, knowledge base/qualifications, level of

clinical autonomy, peer recognition and influence on practice.

Table 1 describes, generally, the expectations for performance at different points along the pathway

towards advanced level practice. They are not mandatory requirements, but provide general

guidance on expectations. Each individual pharmacist’s pathway or ‘program of study’ will be unique

as it will encompass the range of education, professional development and workplace activities that

have supported them (or are supporting them) to achieve advanced level practice.

5 National Competency Standards Framework for Pharmacists in Australia. Canberra: Pharmaceutical Society of Australia; 2010

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Table 1. General characteristics of pharmacists working towards achieving advanced level

performance6

6 Advanced Pharmacy Practice Framework Steering Committee. An Advanced Pharmacy Practice Framework for Australia. October 2012.

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2. GuidingprinciplesforthecredentialingofadvancedpracticepharmacistsinAustraliaThe following principles represent the foundations on which the evaluation standards, policies and

procedures for the credentialing of advanced practice pharmacists have been developed.

Principle 1. Recognition of advanced practice is conducted with the objective of enhancing the

capacity of pharmacists to contribute to health care.

A fundamental premise of effective health care is the provision of services that meet the needs of

the public. When these needs change, appropriate modification to the type and manner in which

health care services are delivered is required.7

In Australia, the ageing population has impacted on the health‐related services provided by health

care professions. Increasing age brings with it an increase in the number of co‐existing disease

states, and a resultant increase in therapeutic intervention and complexity. For pharmacists, these

changes provide both challenges and opportunities for the individual practitioner and the

profession.

Credentialing of advanced practice is not intended to be applied in a way that restricts or constrains

the delivery of professional services. Instead, the standards, policies and processes by which

advanced practice pharmacists are credentialed will encourage a culture of lifelong learning and

ongoing professional development, with a pathway to progress to a more prominent place as an

expert in medicines use, recognised and respected by other health professions and the public.

Principle 2. The credentialing of advanced practice pharmacists will support consumer

participation in health.

Active consumer participation in decision‐making in individual care leads to improvements in health

outcomes. Access to quality information facilitates decision‐making and supports an active role for

consumers in managing their own health.8,9

The standards, policies and processes by which advanced practice pharmacists are credentialed will

be applied in a way that facilitates consumer understanding and decision‐making in their individual

health care.

Principle 3. Practitioner development is a key element of achieving practice at an advanced level,

with support and recognition required along the continuum.

A culture of lifelong learning, ongoing professional development and career progression will be

encouraged in the process for becoming credentialed.

Other organisations (e.g. professional organisations, educational institutions) have an important role

in supporting pharmacists to develop and implement individualised, needs‐based professional

7 Advanced and Extended Pharmacy Practice: An environmental snapshot. Canberra: Australian Pharmacy Council; 2013. At: http://pharmacycouncil.org.au/content/index.php?id=32 8 The evidence supporting consumer participation in health. Consumer Focus Collaboration; May 2001. At: http://www.healthissuescentre.org.au/documents/items/2008/08/226174‐upload‐00001.pdf 9 Australian Commission on Safety and Quality in Health Care. Patient‐centred care: Improving quality and safety through partnerships with patients and consumers. ACSQHC: Sydney; 2011. At: http://www.safetyandquality.gov.au/wp‐content/uploads/2012/03/PCC_Paper_August.pdf

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development plans throughout their career. The Australian Pharmacy Council (APC) will work in

collaboration with these organisations to achieve consistency and quality in the readiness support10

provided to pharmacists preparing for the credentialing process. Ongoing professional development

will be encouraged through the feedback provided.

Principle 4. Advanced practice is credentialed through a single, uniform and independent

assessment process.

The APC was endorsed by the organisations that represent the pharmacy profession in Australia as

the independent assessment entity being responsible and accountable for the credentialing of

advanced practitioners.

The electronic online system developed for submission of portfolios will be user‐friendly and support

standardised portfolio preparation and assessment.

Principle 5. The processes for credentialing are fair, transparent and robust.

For the assessment and credentialing of advanced pharmacy practice:

Standards and processes are developed with broad consultation, enabling the profession

and the community to be confident in the credentials awarded.

Due regard is given to the pharmacist’s reasonable expectations of, and legal rights to,

privacy and confidentiality.

Processes will be conducted with transparency enabling the profession, the health care team

(including practitioners and management), and the community to be confident that

governance and professional responsibilities are being fulfilled.

Principle 6. Only those who have been externally evaluated and credentialed may use the title

Advanced Practice Pharmacist.

Advanced practice is only recognised by credentialing following external evaluation of a pharmacist’s

portfolio according to the standards, policies and processes of the APC.

Absence of a credential therefore does not necessarily reflect lack of performance at an advanced

level. However, standard titles with consistent meanings will facilitate consumer understanding and

decision‐making in relation to their health care options.

10 In this context, ‘readiness support’ may include such things as consideration of the individual pharmacist’s practice against the Performance Criteria in the Advanced Pharmacy Practice Framework, reviewing evidence for inclusion in a portfolio to assess its suitability for supporting claims of performance; and developing individualised, needs‐based professional development plans with pharmacists to support their progress towards advanced level performance.

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3. Rolesandresponsibilitiesassociatedwithadvancedpracticerecognition

3.1 Overview of roles and responsibilities

The following table summarises the roles and responsibilities associated with advanced practice

recognition for:

Pharmacists seeking recognition;

Support organisations providing assistance and guidance to candidates; and the

APC as the independent credentialing body conducting credential assessments.

Step 1. Program of study

Step 2. Building a portfolio

Step 3. Evaluation

Pharmacists Collect evidence and establish links to performance criteria in the APPF through critical reflection

Build up portfolio and conduct readiness self‐check and self‐assessment and/or Seek support through readiness support organisations

Submit Pharmacist Practice Portfolio to APC for credential evaluation

Support organisations

CPD, formal education, training, case studies, mentors, peer evaluation, assessments (e.g. objective structured clinical examination (OSCE), viva), development of Defined area and scope of practice competency clusters i.e. aged care, infectious diseases (see Attachment 1)

Support pharmacists in portfolio building, readiness check and assessments (e.g. OSCE, viva)

Nominate panel participants to APC for Pharmacist Practice Portfolio evaluation

APC Optional validation of tools submitted by support organisations

Provide evidence guide for readiness support organisations and individual pharmacists Provide an electronic portfolio system for pharmacists to upload their evidence and plan their learning journey – called the Pharmacist Practice Portfolio

Conduct evidence pre‐check Convene panel Conduct credential evaluation

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4. Governanceforadvancedpracticecredentialing

4.1 Overview

The following diagram provides an overview of the governance structure for advanced practice

credentialing.

4.2 Australian Pharmacy Council

The Australian Pharmacy Council (APC) is the independent, not for profit, accreditation authority for

Australian pharmacy. The APC assists in protecting the public by performing accreditation and

assessment activities that result in the optimisation of health outcomes and contribute to

confidence in the delivery of competent pharmacy services.

In all of its activities, the APC strives to maintain:

• Independence and high ethical standards

• Honesty and transparency

• Accountability to clients and stakeholders

• Evidence‐based decision making and benchmarking

• High quality business processes and outcomes

• Continuous improvement

• Collaborative models of leadership.11

In December 2013, the APC was endorsed by the organisations that represent the pharmacy

profession in Australia as the independent assessment entity being responsible and accountable for

the credentialing of advanced practitioners.

11 Australian Pharmacy Council Strategic Plan 2013‐2016, At http://pharmacycouncil.org.au/content/assets/files/Publications/Strategic%20Plan%202013%20‐%202016_EXTERNAL%20USE%20ONLY.pdf

APC Council

Advanced Practice Credentialing

Committee (APCC)

Credential Evaluator Panel

•Approves the Standards, policies and procedures that lead to the award of credentials

•Develops, monitors and evaluates the Standards, policies and procedures that lead to the award of credentials (for approval by Council)

•Moderates the results of individual credential applications

•Grants advanced practice credentials

•Evaluates individual credential applications according to approved Standards, policies and procedures

•Provides a report to the APCC on their evaluation of individual credential applications

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The Members of the APC Ltd are the pharmacy professional organisations, the Pharmacy Council of

New Zealand, and independent representatives of the Australian pharmacy profession. Current

Councillors can be accessed at http://pharmacycouncil.org.au/content/index.php?id=28

4.3 Advanced Practice Credentialing Committee

The Advanced Practice Credentialing Committee is a standing Committee of the APC that reports to

the CEO. It has been formed to support APC’s role as the independent assessment entity being

responsible and accountable for the credentialing of advanced pharmacy practitioners, as recently

endorsed by the organisations that represent the pharmacy profession in Australia.

The Committee will be responsible for such things as:

• Developing Credential Evaluation Standards for approval by Council.

• Developing Credential Evaluator Competency Standards, selection processes and

training requirements for approval by Council.

• Evaluating the implementation of the advanced practice credentialing system.

• Monitoring the implementation and performance of the advanced practice portfolio

system.

• Moderating results of credential evaluations against a set moderation framework.

• Granting advanced practice credentials according to the approved credentialing process.

• Providing expert advice on competency evaluation and skills assessment.

The Committee Charter and current membership can be accessed at

http://pharmacycouncil.org.au/content/index.php?id=71

4.4 Credential Evaluator Panel

The Australian Pharmacy Council utilises the expertise of appropriate qualified and experienced

people to undertake the evaluation of portfolios for advanced practice credentials.

Panels may be interdisciplinary. Members are selected on the basis of the individual expert

contribution they bring to the Evaluator Panel, and lack of conflict of interest in relation to the

individual pharmacist who has submitted the portfolio.

The Evaluator Panel will be responsible for:

• Evaluating advanced practice portfolios according to the approved credentialing process

• Preparing feedback for pharmacists following the evaluation of their portfolio

• Making recommendations on the outcome of portfolio evaluations to the Advanced

Practice Credentialing Committee.

The competencies, training and selection process for Evaluator Panel members is described in more

detail in section 7.

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4.5 Overarching policies

The following policies of APC apply in the credentialing of advanced practice pharmacists:

Privacy and confidentiality: the APC Privacy Policy can be accessed at

http://pharmacycouncil.org.au/PDF/Privacy%20Policy.pdf

Independence of processes: the APC has the following policies in place to support

independence in its processes:

Conflict of interest policy

Duties and responsibilities of Councillors

Code of conduct for Councillors

Committee members duties and responsibilities

Code of conduct for Committee members

Appeals: an Appeals policy for credentialing will be developed.

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5. Overviewoftheportfoliodevelopmentandevaluationprocess

5.1 Building a portfolio

[See Attachment 1 Performance criteria for advanced pharmacy practice]

The online Pharmacist Practice Portfolio will guide pharmacists through the process of building their

portfolio.

Pharmacist describes area of

practice

Pharmacist defines scope of practice

Pharmacist undertakes self‐assessment

against the standards in their scope of

practice

Pharmacist reviews the

Performance Criteria for Advanced

Pharmacy Practice

Pharmacist gathers evidence of

performance and links it to the

Performance Criteria for Advanced

Pharmacy Practice

Pharmacist undertakes pre‐check

against credentialing requirements

Pharmacist submits portfolio.

Submission accepted only if there is

evidence against all Standards and,

where relevant, at the required

performance levels

Pharmacist describes their area of

Expert Professional Practice

SupportingresourceNational Competency Standards Framework for Pharmacists in Australia 2010

Practice specific APPF

Readiness support organisations

SupportingresourcePerformance Criteria for Advanced Pharmacy Practice


SupportingresourcesStandards for the evaluation and credentialing of advanced pharmacy practice

Section 6.6 Gathering evidence of performance

Readiness support organisations


SupportingresourceReadiness support organisations

Section 6.5 Gathering evidence

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5.2 Portfolio evaluation

APC receives notification of submission

of portfolio and confirms ID and

registration status

APC undertakes preliminary review of

area and scope of practice and area of

Expert Professional Practice for

completeness

APC proposes Evaluator Panel from

verified pool of evaluators based on

pharmacist’s area of Expert

Professional Practice and evaluator

selection process (including conflicts of

interest)

Advanced Practice Credentialing

Committee (APCC) reviews proposed

Evaluator Panel against pharmacist’s

area of Expert Professional Practice

and evaluator selection process and

confirms panel

Evaluators receive pharmacist’s

portfolio for individual review, panel

discussion and viva, if necessary.

Report prepared using standard

template

Report received by APC. Anomalies

identified and resolved, where

possible with evaluators, or referred to

APCC.

If conflicts identified at

any stage, APC

Credentialing Manager

consulted for

reassignment of

portfolio

APCC receives reports and portfolios

for moderation. Credential awarded

and/or feedback to pharmacist

confirmed.


SupportingresourcesNational Competency Standards Framework for Pharmacists in Australia 2010

Section 7 Portfolio evaluation

SupportingresourcesNational Competency Standards Framework for Pharmacists in Australia 2010

Performance Criteria for Advanced Pharmacy Practice


Standards for the evaluation and credentialing of advanced practice pharmacists

Section 6.6 Gathering evidence

SupportingresourceAHPRA online register of practitioners

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5.3 The APC online Pharmacist Practice Portfolio

The APC is in the process of developing an online Pharmacist Practice Portfolio tool that will support

pharmacists and evaluators through the portfolio building and evaluation process, respectively.

While development of the tool is still in the scoping phase, pharmacists should be reassured that

information submitted will be subject to strict controls to protect the integrity, confidentiality,

accessibility, availability and retrieval of that information.

The APC portfolio system will be built on a platform that will allow (with appropriate permissions)

records to be imported from, and exported to, other organisations (e.g. professional bodies,

educational institutions) for portfolio preparation and readiness checks, respectively.

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6. Portfoliopreparation[See Attachment 1 Performance criteria for advanced pharmacy practice]

6.1 Describing area of practice

A pharmacist’s defined area of practice comprises ‘the pharmacist’s area of responsibility and

accountability in professional practice’.

The description of a pharmacist’s area of practice could encompass, as a minimum, their role (e.g.

tasks, authority, accountability), work setting and geographic profile. Pharmacists should ensure

they describe all areas in which they practice, not just their primary area of practice.

6.2 Defining scope of practice

A pharmacist’s scope of practice must be presented according to the National competency standards

framework for pharmacists in Australia. This may be referred to as developing a ‘Role Definition

Grid’ or ‘Professional Practice Profile’.

The process of developing a role definition grid to define scope of practice using the National

competency standards framework for pharmacists in Australia is described within that publication –

refer to steps 1‐4 on page 8.

Domains 1 and 2 are universally applicable. The remaining competency standards selected must be

relevant and sufficient for the area of practice.

6.3 Self‐assessment of competence

A pharmacist must undertake a self‐assessment against each competency standard in their defined

scope of practice. The recency of practice declarations associated with pharmacist registration will

also be considered as evidence.

6.4 Describing area of Expert Professional Practice

From their defined area and scope of practice, a pharmacist’s area of Expert Professional Practice

must be identified:

the Domain(s) from the National competency standards framework for pharmacists in

Australia that best reflect the area of Expert Professional Practice must be identified

within those Domain(s), a specific area of expertise may be appropriate to describe.

6.5 Advanced level performance

Pharmacists wishing to seek recognition at the advanced practice level must demonstrate

performance against the Performance Criteria for Advanced Pharmacy Practice as relevant to the

pharmacist’s area of Expert Professional Practice and the domains universally applicable to all areas

of advanced pharmacy practice.

The Performance Criteria for Advanced Pharmacy Practice build on those in the National competency

standards framework for pharmacists in Australia and are therefore supplementary to them. They

are included as Attachment 1.

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The Performance Criteria for Advanced Pharmacy Practice are grouped into the following areas:

Expert Professional Practice – The Domains from the National competency standards

framework for pharmacists in Australia that are selected to reflect a pharmacist’s area of

Expert Professional Practice.

Networking, Leadership and Influence – The Domains from the National competency

standards framework for pharmacists in Australia within this group are universally

applicable to all areas of advanced pharmacy practice and do not require further

customisation. They are:

o Communication, Collaboration and self‐management

o Leadership and management

o Professional and ethical practice

o Critical analysis, research and education.

Performance can be described at three levels: Transitional, Consolidation or Advanced. Performance

criteria are provided for each level. When evidence is submitted, pharmacists must identify which

level of performance has been demonstrated. For more information about gathering evidence, see

Section 6.6.

To be eligible for credentialing, the pharmacist must be able to demonstrate performance at an

Advanced level for at least 70% of the Performance Criteria for Advanced Pharmacy Practice within

each Domain; and the balance at Consolidation level.

6.6 Gathering evidence of performance

It is the pharmacist’s responsibility to present a case that demonstrates performance at an advanced

level. It is this case that is evaluated.

The portfolio must, therefore, contain both the case being made for performance at an Advanced

level, and the evidence to support this case.

RulesofevidenceEvidence of area and scope of practice and performance can take many forms and be gathered from

a number of sources. However pharmacists should ensure evidence is valid, authentic, current and

sufficient.

Validity: The evidence must be relevant to the claim for which it is being used to support.

The contents of a pharmacist’s portfolio are not prescribed. Pharmacists must carefully consider

what the evidence would be that supports each claim, and to provide a rationale for the

selection of the material.

Pharmacists should be cognisant that it is competence and performance that must be

demonstrated, and not just the attainment of knowledge and skills.

Commentary/critical reflection provided by the pharmacist may be used to justify the relevance

of evidence.

‘Less is more’ in terms of quantity of evidence; what is more important is its quality, the

relevance of each piece to the claim being made, and its integration as referenced within the

commentary/critical reflection.

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Authenticity: There must be evidence included that can verify that the evidence is that of the

pharmacist and/or, if part of a team contribution, what aspects were specific to the pharmacist

(e.g. testimonial statements from colleagues, opportunity to verify qualifications with issuing

body, etc)12

Currency: The evidence must relate to a relatively recent time period (e.g. less than five years).

Where evidence relates to the past (e.g. a qualification), further evidence to demonstrate the

knowledge/skills are still applied in practice would be expected.

Sufficiency: There must be enough evidence to demonstrate performance at the identified level

(i.e. Advanced Level or Consolidation level).

12 Portfolio. In: National Quality Council. Guide for developing assessment tools. TVET Australia; 2009.

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ExampleevidencesourcesThe follow table lists examples of information that may be included in a portfolio as evidence of a

pharmacist’s performance. Pharmacists will be guided to consider the criterion (or criteria) to which

the evidence they have submitted relates and the level of performance it demonstrates (transition,

consolidation or advanced level) – see Attachment 1 Performance criteria for advanced pharmacy

practice.

Example evidence sources13 Example documentation for inclusion in portfolio

Knowledge base/ qualifications

Postgraduate qualifications or equivalent

CPD

Publications

Certified copy of certificate and academic transcript

Certificate of attendance and flyer listing learning objectives and presenter name and credentials

Copy of article

Experiential background

Documented examples of management of medication problems in complex cases

Communication/defending of controversial information to multidisciplinary peers

Written reports prepared for meetings and verbal presentation

Member of, or provide advice to, a local, regional, national or international group or committee

Written reports prepared for meetings and verbal presentation

Level of autonomy

Job description, e.g. indicating responsibility for certain activities (e.g. approving new drugs usage)

Job description accompanied by signed and dated letter from manager/employer verifying job description and the dates for which it has applied

Peer recognition

Invited to speak at National/International conferences

Communications via various media

Requests from regulatory/advisory bodies, courts of law, etc for opinion/advice

Peer reviewer for academic journal

Reviews of protocols at local or national level

Provide advice to professional/strategy bodies

Multi‐source feedback tools (also called peer assessment, 360‐degree feedback, peer review, peer rating)

Conference program

Copy of communications

Records of requests

Copy of (or link to) listing

13 Competency Development and Evaluation Group. Advanced and consultant level competency

framework. 3rd Edition, February 2005.

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Influence on practice

Development of treatment guidelines, protocols or standards of practice at a local or national level

Introduction of new services or new ways of working; introduction of systems to reduce medication risk

Contribution to a local strategy for quality use of medicines

Implementation of trial data into local practice procedures and policy

Quality improvement projects (e.g. Documented audits of prescribing quality)

Published research papers

Editor of reference book or chapters in specialist area

Leader of development and adoption of new policy or procedure at national level

Performance appraisal for staff

Examples of evidence that pharmacists may acquire during their work that demonstrate evidence of

outcomes in the area of Networking, Leadership and influence (which includes: Communication,

collaboration and teamwork; Leadership and Management; and Critical analysis, research and

education) are illustrated in Figure 2.

Figure 2. Examples of evidence to be included in a portfolio demonstrating development towards

advanced practice (adopted from S Stacey with permission)

Advanced practice

Expert professional practice



Leadership and

management

Critical analysis,

research and education

Clinical experience (Rotations)

Postgraduate Qualifications

Team Leader role

Member Committees & Working Groups

Research Projects

Drug use evaluation

Posters at conference

Observation Assessments You + others

Published Papers

Seminars & Conferences

Audits + feedback

Performance management of others

Honorary academic

Lectures & Inservices

Pharm, RN, Dr

Project Management

Student/ intern Supervision

Case Presentations

Visit other hospitals

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6.7 Pre‐check against credentialing requirements

Before submission of a portfolio, pharmacists should check the following:

Have I self‐assessed against each Competency Standard in my defined scope of practice?

Is there evidence mapped against each criterion of the Performance Criteria for Advanced

Pharmacy Practice? For at least 70% of the performance criteria in each Domain, is

performance identified to be at an advanced level and the balance at consolidation level?

For each criterion:

Does the evidence clearly align with the expectations described in the Advanced Pharmacy

Practice Framework?

Does the evidence clearly align with the expectations described for the specific Performance

Level identified?

Is it clear that the evidence relates to the pharmacist’s contribution to the outcome? Or, if

part of a collaborative effort, is the pharmacist’s input to achieving the outcome clear?

Does the evidence demonstrate current and sustained performance?

Has enough evidence been provided?

If not, it should be considered whether additional evidence is needed to support the claim. Does the

evidence exist? Or is further development of the individual required in order to be eligible?

Pharmacists who need support in building their portfolio are referred to support organisations to provide assistance and guidance (e.g. Pharmaceutical Society of Australia, Society of Hospital Pharmacists, Pharmacy Guild of Australia, Australian College of Pharmacy).

6.8 Fees associated with evaluation and credentialing

Fees associated with the evaluation and credentialing of portfolios are yet to be determined.

As a not for profit organisation, APC will set fees on a cost recovery model:

An annual fee will be established that reflects the costs associated with the ongoing

maintenance of a pharmacist’s portfolio.

A one‐off fee will be established that reflects the cost associated with evaluation of a

portfolio and credentialing.

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7. Portfolioevaluation

7.1 Evaluator Panel member competencies

Members of the Evaluator Panel should have competencies (individually or collectively) in:

The relevant area of practice at least to the level being evaluated; and

Using evidence for evaluation and upholding evaluation independence, quality and

standards.

Advanced Pharmacy Practice Framework Minimum evidence requirements

Expert professional practice

[Relevant domains to be identified for the individual pharmacist] 1. Expert knowledge and skills 2. Accountability and responsibility 3. Reasoning and judgement 4. Professional autonomy

Has undergone an external process of validation with a recognised authority in their area of expert professional practice

Substantive contribution to their area of expert professional practice

Formal education and degree in their area of expert professional practice

Networking, leadership and influence

Domain 1: Professional and ethical practice 1. Apply and monitor standards of practice 2. Contribute to Continuing Professional

Development (CPD) of self and others

Domain 2: Communication, collaboration and self‐management 1. Use appropriate communication skills 2. Engage in teamwork and consultation 3. Work across boundaries

Domain 3: Leadership and management 1. Understand strategic context and contribute to

strategic planning 2. Understand and contribute to clinical

governance 3. Understand and contribute to the strategic

vision 4. Contribute to innovation and service

development 5. Motivate self and others 6. Support and assist implementation of national

priorities 7. Understand and contribute to the effective use

of resources 8. Contribute to the identification and effective

management of risk 9. Promote improved performance 10. Understand and undertake project

management 11. Understand change management principles

and lead change 12. Serve as a role model and mentor for others

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Domain 8: Critical analysis, research and education 1. Conduct of education and training 2. Links practice and education 3. Educational policy 4. Undertake critical evaluation activities 5. Identify gaps in evidence base 6. Design and deliver research projects to address

gaps in the evidence base 7. Apply research evidence into practice 8. Supervise others undertaking research 9. Establish research partnerships

Evaluation skills Minimum evidence requirements

Using evidence for evaluation

1. Conduct systematic inquiries 2. Assess evidence from multiple sources for

validity, authenticity, currency and sufficiency 3. Respect the uniqueness of the evaluation and

the individual 4. Address conflict in evaluation findings 5. Report on and make recommendations based

on evaluation findings

Current training in gathering and using evidence for evaluation for the purpose of credentialing14

Upholding evaluation independence, quality and standards

1. Display honesty and integrity in their own behaviour

2. Support honesty and integrity in the entire evaluation process

Current training in assuring independence and quality in evaluation for the purpose of credentialing, as delivered by APC

Potential Evaluator Panel members will be identified through a process of obtaining Expressions of

Interest and evaluation by the Advanced Practice Credentialing Committee. A pool of potential

Evaluator Panel members will be developed over time from which to select panels for specific

applications.

Statements declaring conflicts of interest must be completed annually by potential Evaluator Panel

members. The ongoing inclusion of individuals in the pool of potential Evaluator Panel members will

be verified on an annual basis.

14 This may include the Assessor skill set from the Certificate IV in Training and Assessment, or the training provided by APC by Evaluators

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7.2 Evaluator Panel member training

Evaluator Panel members will be expected to complete online training on an annual basis.

On completion of the training, members will be expected to:

Have an understanding of the APC Advanced Practice Credentialing process

Understand expectations for honesty, integrity, independence and confidentiality

Recognise the various standards used within the credentialing process and when they should

be applied

Be able to systematically evaluate evidence from multiple sources for validity, authenticity,

currency and sufficiency

Understand the unique context from which each application will be developed

Recognise their own limitations in evaluating portfolios and know how to manage these

Recognise the purpose of a viva voce in the evaluation process and be able to conduct one

that is rigorous, fair, reliable and consistent.

Record evaluation findings in a standard format and make a recommendation based on

these findings.

7.3 Selection process for a specific Evaluator Panel

The members of an Evaluator Panel will be nominated and selected according to the requirements

of the pharmacist. The process will include the following steps:

1. On submission of an application, the APC will undertake a preliminary review of the

pharmacist’s defined area and scope of practice, and the pharmacist’s nominated area of

expert professional practice.

2. The pool of potential Evaluator Panel members will be considered as follows:

a. members with an area of expert professional practice that aligns with that of the

pharmacist will be identified; and

b. the curriculum vitae or resume of the pharmacist will be reviewed to identify any

obvious conflicts of interest with potential evaluator panel members.

3. ‘Matched’ Evaluator Panel members will be contacted for potential availability for the

evaluation; the curriculum vitae of the pharmacist will be shared in order to confirm the

pharmacist is not known to the evaluator and to explore any other real or perceived

conflicts.

4. The APC will nominate potential Evaluator Panel members for the Advanced Practice

Credentialing Committee (APCC) to select a three‐member panel.

When no suitable Evaluator Panel members can be identified from the pool, the APC with the APCC

will make contact with relevant recognised authorities (e.g. those that offer an external process of

validation) in the particular area of expert professional practice to seek potentially suitable

evaluators.

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7.4 Evaluation of portfolio

On assignment of a portfolio, each member of the Evaluator Panel will individually assess the

evidence submitted according to the Standards for the evaluation and credentialing of advanced

practice pharmacists. These are included as Attachment 2.

Evaluators will be expected to develop a report that records their findings in a standard format and

makes a recommendation as to whether the pharmacist is eligible for credentialing.

The Evaluator Panel members will have the opportunity to discuss their findings with each other, to

determine whether a viva voce (viva) is required, and if it is, to clarify its purpose and focus. A viva

will only be conducted at the request of the Evaluator Panel to clarify and confirm a pharmacist’s

evidence of performance, and should not be considered a right of all pharmacists submitting a

portfolio. Pharmacists will be advised of the purpose of the viva to enable them to prepare in an

informed way.

On receipt of the Evaluator Panel member reports, the APC will review the reports for anomalies

between the panel members’ findings and recommendations. If anomalies are apparent, the APC

will attempt to resolve these between the panel members.

Where anomalies cannot be resolved, they will be referred to the Advanced Practice Credentialing

Committee (with the Evaluator Panel reports) for consideration.

7.5 Moderation of reports and feedback to pharmacist

Moderation is a quality assurance process that ensures evaluations are undertaken appropriately

and consistently.

The reports of the Evaluator Panel for each pharmacist will be considered at a meeting of the

Advanced Practice Credentialing Committee (APCC). For each pharmacist:

The records of findings from each Evaluator Panel member will be reviewed and endorsed;

and

The recommendation by each Evaluator Panel member will be verified and endorsed; and

A credential will be awarded and/or feedback to the pharmacist confirmed.

The feedback to the pharmacist is intended to be sufficient to provide clarity on the rationale for the

decision made by the APCC and to support the pharmacist’s ongoing professional development.

7.6 Award of credential

Credentials will be awarded for a five year period, after which time revalidation will be required.

A public record of credentialed Advanced Practice Pharmacists will be maintained on the APC

website.

During the period for which the credential is awarded, pharmacists will be entitled to use the post

nominal: Adv Prac Pharm.

7.7 Revalidation

Re‐validation will involve submission of evidence of maintenance of performance at an Advanced

level.

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8. Glossary15,16Term Definition

Accountability Being answerable for one’s actions, and the roles and responsibilities inherent in one’s job or position. Accountability cannot be delegated.

Advanced pharmacy practice

Practice that is so significantly different from that achieved at initial registration that it warrants recognition by professional peers and the public of the expertise of the practitioner and the education, training and experience from which that capability was derived

Autonomy Having a sense of one’s own identity and an ability to act independently and to exert control over one’s environment, including a sense of task mastery, internal locus of control, and self‐efficacy

Competence Possession by an individual of the required knowledge, skills and attributes sufficient to successfully and consistently perform a specific task or function to the desired standards

Defined area of practice

The pharmacist’s area of responsibility and accountability in professional practice

Peer review The evaluation by a practitioner of creative work or performance by other practitioners in the same field in order to assure, maintain and/or enhance the quality of work or performance

Performance level A characteristic of professional practice that reflects the knowledge, skills and experience of the pharmacist

Portfolio Formal documentation of training, achievements and experience

Readiness support In this context, ‘readiness support’ may include such things as:

Consideration of the individual pharmacist’s practice against the Performance Criteria in the Advanced Pharmacy Practice Framework

Reviewing evidence for inclusion in a portfolio to assess its suitability for supporting claims of performance; and

Developing individualised, needs‐based professional development plans with pharmacists to support their progress towards advanced level performance.

Responsibility To be entrusted with or assigned a duty or charge. In many instances responsibility is assumed, appropriate with one’s duties. Responsibility can be delegated as long as it is delegated to someone who has the ability to carry out the task or function. The person who delegated the responsibility remains accountable, along with the person accepting the task or function.

Scope of practice A time sensitive, dynamic aspect of practice which indicates those professional activities that a pharmacist is educated, competent and authorised to perform and for which they are accountable.

15 Glossary. In: An Advanced Pharmacy Practice Framework for Australia; October 2012. 16 Advanced and Extended Pharmacy Practice: An environmental snapshot. Canberra: Australian Pharmacy Council; 2013. At: http://pharmacycouncil.org.au/content/index.php?id=32

ATTACHMENT 1

Page 1 of 6

DRAFT Performance criteria for advanced pharmacy practice

Advanced Pharmacy Practice Framework

Performance level descriptor examples

Expert Professional Practice Transition level Consolidation level Advanced level

In defined area and scope of practice

(underpinned by standards in the National Framework for which expert professional practice is claimed)

1. Acquire expert knowledge and skills

Demonstrates general knowledge in core practice areas

Able to plan, manage, monitor, advise and review performance in core practice areas

Demonstrates comprehensive, high level knowledge in defined practice area(s)

Able to plan, manage, monitor advise and review programs in defined practice area(s)

Advances knowledge in defined practice area(s)

Advances programs in defined practice area(s)

2. Demonstrate accountability and responsibility

Demonstrates ability to compare options or apply analytical skills in a range of routine situations

Demonstrates ability to recognise priorities when problem solving and identify deviations from the normal pattern

Applies established practice protocols in responding to situations

Demonstrates ability to make decisions in complex situation where several factors require analysis, interpretation and comparison

Demonstrates ability to interpret and synthesise available evidence and/or data to assess situations and options

Seeks guidance where variations to established practice/protocols are indicated

Demonstrates ability to apply expertise to assess complex and dynamic situations

Demonstrates ability to assess situations and options in the absence of evidence or data or where there is conflicting evidence or data

Uses judgment to vary practice to respond to contextual requirements

3. Use reasoning and judgement

Accepts accountability for services delivered directly to individual service recipients

Applies expertise responsibly in delivery of services in routine situations

Demonstrates capacity to identify research findings likely to impact on practice

Accepts accountability for services delivered to a defined group

Accesses and applies evidence based advice/strategies in complex situations

Demonstrates a responsible approach to integrating evidence into practice

Accepts accountability for services delivered in a defined practice area(s)

Applies expertise confidently to provide services and advice in complex, unpredictable or unfamiliar circumstances

Appraises and integrates new evidence in an innovative and collaborative approach to planning and delivery of services

ATTACHMENT 1

Page 2 of 6

4. Use professional autonomy

Uses expertise to contribute to services delivered to individual service recipients in routine situations

Demonstrates ability to follow legal, ethical, professional and organisational policies/procedures and codes of conduct

Uses available evidence and established practice procedures to provide input to services

Demonstrates ability to act according to personal interpretation of broad professional polices/procedures where necessary

Makes autonomous decisions about services that are informed by expert knowledge, judgment, available evidence and treatment goals or outcomes

Demonstrates ability to interpret government health care policy and strategy to establish policies/procedures, codes and/or standards for others within defined practice area(s)

ATTACHMENT 1

Page 3 of 6

Networking, Leadership and Influence Transition level Consolidation level Advanced level


(underpinned by standards in Domain 1 of the National Framework)

1. Apply and monitor standards of practice

Demonstrates understanding of, and conforms to relevant standards of practice

Accountable for setting and monitoring standards of practice at the team level

Accountable for setting and monitoring standards of practice beyond the team

2. Contribute to Continuing Professional Development (CPD) of self and others

Demonstrates self‐development through regular CPD and the application of learning to practice

Acts as a CPD facilitator for the profession

Shapes and contributes to the CPD strategy for the profession or other disciplines



1. Use appropriate communication skills

Demonstrates use of appropriate communication to gain the cooperation of individual patients, colleagues and other health professionals

Demonstrates ability to communicate effectively where content of discussion is explicitly defined

Demonstrates use of appropriately selected communication skills to gain co‐operation of patients, colleagues, clinicians and/or managers

Demonstrates ability to communicate effectively where the content of the discussion is based on personal opinion

Demonstrates ability to present complex, sensitive or contentious information to large groups of patients, clinicians and/or managers

Demonstrates ability to communicate effectively in a hostile, antagonistic or highly emotive atmosphere

2. Engage in teamwork and consultation

Demonstrates ability to work as a member of the pharmacy team

Recognises personal limitations and demonstrates ability to refer to more experienced colleagues

Demonstrates ability to work as a member of a multidisciplinary team

Accepts expert advice through consultation within the workplace/organisation

Works across workplace boundaries to build relationships and share information, plans and resources

Provides expert advice within and beyond the workplace/organisation as a recognised opinion leader

3. Work across boundaries

Demonstrates ability to extend boundaries of service delivery within the pharmacy team

Demonstrates ability to extend the boundaries of service delivery across more than one team

Demonstrates the value of extending the boundaries of service delivery across professions and/or the external environment

ATTACHMENT 1

Page 4 of 6



1. Understand strategic context and contribute to strategic planning

Demonstrates understanding of the needs of stakeholders, and practice reflects government health care policy

Understands formal structure in which they work

Demonstrated ability to plan up to 12 months ahead and in alignment with established strategy

Demonstrates ability to incorporate government health care policy or priorities to influence local strategy

Understands culture and climate of the workplace

Demonstrated ability to plan more than one year ahead taking account of strategic plan

Participates in development of government health care policy/ strategy or priorities and leads its integration into local strategy

Understands the internal and external practice environment

Demonstrated ability to develop a long term plan taking a holistic view of the practice environment

2. Understand and contribute to clinical governance

Demonstrates understanding of the pharmacist’s role in clinical governance and practice reflects the workplace framework

Influences the clinical governance agenda for the team

Shapes and contributes to the clinical governance agenda of the workplace/organisation

3. Understand and contribute to the strategic vision

Demonstrates understanding of, and contributes to, the vision for professional services

Creates the vision for professional services and translates it into clear goals for the pharmacy team

Influences groups of colleagues, clinicians and/or managers to share the vision for professional services

4. Contribute to innovation and service development

Demonstrates ability to improve the quality or range of services with limited supervision

Applies priorities set by others to develop clear plans for services based on review of recent past performance

Recognises and implements innovation from the external environment without supervision

Develops future plans for professional services based on a clear understanding of priorities

Leads efforts to ensure innovation produces demonstrable improvement in service delivery

Relates goals and actions to strategic aims of the workplace or profession

5. Motivate self and others

Demonstrates ability to self motivate to achieve goals

Demonstrates ability to motivate individuals in the team

Demonstrated ability to motivate individuals beyond the team

6. Support and assist implementation of national priorities

Demonstrates understanding of the implications of national health care priorities for the team

Influences the response of the team to national health care priorities

Leads response of the team to national health care priorities

7. Understand and contribute to the effective use of resources

Demonstrates understanding of the process for effective resource utilisation

Demonstrates effective management of resources

Demonstrates ability to assess and reassign resources to improve effectiveness of use

ATTACHMENT 1

Page 5 of 6

8. Contribute to the identification and effective management of risk

Demonstrates ability to identify and resolve risk management issues using established policy/procedure

Is accountable for developing risk policy/procedure for managing existing and newly identified risks at team level

Is accountable for developing policy/procedure for managing existing and newly identified risks beyond the team

9. Promote improved performance

Contributes to performance management processes in accordance with established policy/procedure.

Refers appropriately to colleagues for guidance as required

Is accountable for performance management of team members

Is accountable for performance management of the team as a whole

10. Understand and undertake project management

Demonstrates understanding of the principles of project management and manages simple projects. Refers appropriately to colleagues for guidance as required

Demonstrates ability to successfully manage a project at team level

Demonstrates ability to plan and supervise the implementation of a project

11. Understand change management principles and lead change

Demonstrates understanding of the principles of change management

Demonstrates ability to manage a change process for the team

Demonstrates ability to lead a change process beyond the team/workplace or across disciplines

12. Serve as a role model and mentor for others

Understands and demonstrates the characteristics of a role model to members of the team

Demonstrates understanding of the mentorship process

Demonstrates the characteristics of an effective role model within and beyond the team

Demonstrates ability to effectively mentor others within the team

Demonstrates ability to engender role model behaviour in others

Demonstrates ability to effectively mentor outside the team

Critical analysis, research and education


1. Conduct of education and training

Demonstrates an understanding of current educational policy

Demonstrates ability to conduct teaching efficiently according to an agreed plan with guidance from a more experienced colleague

Demonstrates ability to interpret national policy in order to design strategic approaches for local workforce education

Able to assess the performance and learning needs of others

Demonstrates ability to plan a series of effective learning experiences for others

Shapes and contributes to national education policy

Demonstrates ability to design and manage a course of study, with appropriate use of teaching assessment and study methods

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2. Links practice and education

Participates in the formal education of undergraduate and postgraduate students

Participates in the education and training of formal special interest groups in the external environment

Shapes, contributes to, or is accountable for the creation or development of higher education qualification(s)

3. Educational policy Demonstrates an understanding of current educational policies in health services

Demonstrates ability to interpret national policy in order to design strategic approaches to local workforce education

Shapes and contributes to national educational policy

4. Undertake critical evaluation activities

Demonstrated ability to critically evaluate literature sources

Demonstrated application of critical evaluation skills in the context of practice

Recognised as undertaking peer review activities in practice

5. Identify gaps in evidence base

Demonstrates ability to identify gaps in the evidence base for practice

Demonstrates ability to formulate appropriate and rigorous research questions to address evidence gaps

Demonstrates ability to design an appropriate research strategy to address research questions

6. Design and deliver research projects to address gaps in the evidence base

Demonstrates ability to describe the core features of research protocols

Demonstrates ability to generate evidence suitable for presentation at the local level

Demonstrates ability to design a research protocol to address previously formulated research questions

Demonstrates ability to generate new evidence suitable for presentation at research symposium

Demonstrates active involvement in critical review of research protocols

Demonstrates authorship of primary evidence outcomes in peer reviewed media

7. Apply research evidence into practice

Demonstrates ability to apply research into own practice

Demonstrates ability to apply evidence‐based practice within the team

Is able to use research evidence to shape workplace/organisational policy/procedure

8. Supervise others undertaking research

Demonstrates understanding of research governance

Is able to contribute to research supervision in collaboration with research experts

Is a research project supervisor for postgraduate students

9. Establish research partnerships

Demonstrates ability to work as a member of a research team

Demonstrates ability to establish new multidisciplinary links to conduct research projects

Demonstrates ability to show leadership within research teams concerning the conduct of research

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DRAFT Standards for the evaluation and credentialling of advanced practice pharmacists

Introduction ‘Professional practice may be viewed as a continuum based on the post‐registration learning that has

occurred through all means available to the individual pharmacist. At some point along the continuum

there is a ‘threshold’ performance level above which performance could be considered ‘advanced’ while

below that threshold performance would be considered to be at the ‘general’ level.’1

The performance continuum from ‘general’ level to Advanced level progresses through Transition and

Consolidation levels.

Advanced practice is ‘practice that is so significantly different from that achieved at initial registration that

it warrants recognition by professional peers and the public of the expertise of the practitioner and the

education, training and experience from which that capability was derived’.2

These Standards specify the minimum requirements for award of a credential as an Advanced Practice

Pharmacist.

Standard 1 Current registration This Standard ensures that only pharmacists registered with the Pharmacy Board of Australia are eligible to

be recognised as Advanced Practice Pharmacists.

Element Assessment Criteria Evidence examples

1.1 The applicant must demonstrate they are the person seeking to be recognised

The applicant must provide photographic evidence that they are the person seeking to be recognised.

Certified copy of passport or driver’s license

1.2 The applicant must be registered with the Pharmacy Board of Australia

The applicant must hold current general or limited registration with the Pharmacy Board of Australia.

AHPRA registration number

1 Section 1. In: An Advanced Pharmacy Practice Framework for Australia; October 2012. 2 Introduction. In: An Advanced Pharmacy Practice Framework for Australia; October 2012.

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Standard 2 Area and scope of practice This Standard ensures that the area and scope of practice is clearly defined and relevant to pharmacy

practice.


2.1 The pharmacist’s area of practice is defined.

The defined area of practice comprises ‘the pharmacist’s area of responsibility and accountability in professional practice’.3

The pharmacist’s area of practice is verified by an appropriate third party.

Job description

Curriculum vitae

Role verification by supervisor and/or colleague

2.2 The pharmacist’s scope of practice4 accurately reflects the pharmacist’s defined area of practice.

The scope of practice must be presented according to the National competency standards framework for pharmacists in Australia5.

Domains 1 and 2 are universally applicable.

Competency standards must be relevant and sufficient for the area of practice.

Role definition grid or Professional Practice Profile

The process of developing a role definition grid to define scope of practice using the National

competency standards framework for pharmacists in Australia (the ‘National Framework’) is described

within that publication – refer to steps 1‐4 on page 8.

3 Glossary of terms. In: An Advanced Pharmacy Practice Framework for Australia; October 2012. 4 Scope of practice is a time sensitive, dynamic aspect of practice which indicates those professional activities that a pharmacist is educated, competent and authorised to perform and for which they are accountable. 5 National competency standards framework for pharmacists in Australia. At: www.psa.org.au/supporting-practice/national-competency-standards

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Standard 3 Competence This Standard ensures that pharmacists wishing to seek recognition at the advanced practice level can first

demonstrate competence against the competency standards that define their area and scope of practice.6


3.1 The pharmacist must be able to demonstrate current competence for their defined area and scope of practice

The pharmacist must meet the recency of practice registration standard set by the Pharmacy Board of Australia.

AHPRA registration number and record within AHPRA Register of Practitioners

The pharmacist must not be identified as being ‘non‐practising’, having registration suspended, or having a condition placed on registration that stops them from practising.

AHPRA registration number and record within AHPRA Register of Practitioners

The pharmacist must self‐assess against the competency standards for their defined area and scope of practice.

Self‐assessment

6 Section 3 – The Advanced pharmacy practice framework. In: An Advanced Pharmacy Practice Framework for Australia; October 2012.

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Standard 4 Performance at an advanced level This Standard ensures that pharmacists wishing to seek recognition at the advanced practice level can

demonstrate performance against the Performance criteria for advanced pharmacy practice, as relevant to

the pharmacist’s defined area of Expert Professional Practice.

Element Assessment Criteria Evidence examples7

4.1 The pharmacist’s area of practice for which recognition of advanced practice is sought is defined.

The Domain(s) in the National competency standards framework for pharmacists in Australia from which their area of Expert Professional Practice stems are identified

From within those Domain(s), specific details that describe their area of expert professional practice are provided

The Performance criteria for advanced pharmacy practice* in the area of Expert Professional Practice are contextualised by the evidence mapped against them, and reflect the pharmacist’s identified area of Expert Professional Practice.

The Performance criteria for advanced pharmacy practice in the area of Networking, Leadership and Influence are universally applicable to all areas of advanced pharmacy practice.

Job description

Curriculum vitae

Role verification by supervisor and/or colleague

4.2 The pharmacist is able to demonstrate performance at an Advanced Level for at least 70% of Performance criteria for advanced pharmacy practice within each Domain; and the balance at Consolidation level.

Evidence is mapped against the Performance criteria for advanced pharmacy practice and supports the claims made by the pharmacist

Evidence provided demonstrates breadth and depth of practice and peer and/or patient feedback.

Relevant evidence will be unique to the individual. See handbook for guidance.

Multisource feedback is important (including managers, colleagues and consumers)

7 Adapted from Competency Development and Evaluation Group (CoDEG). Advanced to Consultant level Framework. United Kingdom: CoDEG; 2009. p18

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Pharmacists seeking recognition at the advanced practice level are required to demonstrate

performance at an advanced level in the areas (and Domains) of:

o Expert Professional Practice (Domains as relevant to the individual pharmacist); and

o Networking, Leadership and Influence, in the Domains:

Communication, Collaboration and self‐management



Critical analysis, research and education.

The Performance criteria for advanced pharmacy practice are available as a separate document.

As a general guide, pharmacists wishing to seek recognition at the advanced practice level will have

more than 5 years’ experience in their defined area of practice. However this is only guidance, and not

a mandatory requirement.

As a general guide, pharmacists wishing to seek recognition at the advanced practice level will hold a

relevant postgraduate qualification of at least Graduate Diploma level. However this is only guidance,

and not a mandatory requirement.

It is expected that pharmacists wishing to seek recognition at the advanced practice level will be

working independently and influencing practice at state or national level, guiding (by direct supervision

or mentoring) other advanced level pharmacists, and acknowledged within a multidisciplinary team as

a leader in the defined area of practice.

Pharmacists will be required to provide commentary/critical reflection describing how such things as

their experiential background, knowledge base/qualifications, level of clinical autonomy, peer

recognition and influence on practice demonstrates performance at an advanced level.

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Glossary8

Term Definition

Accountability Being answerable for one’s actions, and the roles and responsibilities inherent in one’s job or position. Accountability cannot be delegated.

Advanced pharmacy practice

Practice that is so significantly different from that achieved at initial registration that it warrants recognition by professional peers and the public of the expertise of the practitioner and the education, training and experience from which that capability was derived

Autonomy Having a sense of one’s own identity and an ability to act independently and to exert control over one’s environment, including a sense of task mastery, internal locus of control, and self‐efficacy

Competence Possession by an individual of the required knowledge, skills and attributes sufficient to successfully and consistently perform a specific task or function to the desired standards

Defined area of practice

The pharmacist’s area of responsibility and accountability in professional practice

Peer review The evaluation by a practitioner of creative work or performance by other practitioners in the same field in order to assure, maintain and/or enhance the quality of work or performance

Performance level A characteristic of professional practice that reflects the knowledge, skills and experience of the pharmacist

Responsibility To be entrusted with or assigned a duty or charge. In many instances responsibility is assumed, appropriate with one’s duties. Responsibility can be delegated as long as it is delegated to someone who has the ability to carry out the task or function. The person who delegated the responsibility remains accountable, along with the person accepting the task or function.

Scope of practice A time sensitive, dynamic aspect of practice which indicates those professional activities that a pharmacist is educated, competent and authorised to perform and for which they are accountable.

8 Glossary. In: An Advanced Pharmacy Practice Framework for Australia; October 2012.

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