How online learning supports SQPs and RAMAs Episode 2: managing veterinary medicines

RCVS Knowledge:
Welcome to this four-part series for Suitably Qualified Persons also known as Registered Animal Medicines Advisors. This series is a collaboration between RCVS Knowledge and AMTRA.

This podcast series will highlight how the courses on the RCVS Knowledge Learn platform can be used for your self-reflection CPD. To access any of the courses mentioned, head to learn.rcvsknowledge.org and set up your free account.

This week’s episode covers Modules 3 and 4 of the Managing Veterinary Medicines course: Dispensary management and QI in the dispensary: Preventing errors.

Pam Mosedale:
Hi everyone. Today I’m going to talk to Melissa and Stacey about the SQP/RAMAs role and how that’s involved in running the dispensary. Stacey is an SQP/RAMA and has been an SQP assessor and works at Lantra. Melissa works at Pets at Home
Central Office, but she has worked on the shop floor too as an SQP/RAMA. So welcome both of you.

Melissa:
Thank you.

Stacey Bullock:
Thank you.

Pam Mosedale:
So what we’re going to talk about is some CPD that we’ve got available at RCVS Knowledge jointly produced with the VMD around managing veterinary medicines and how this may or may not be useful for SQP/RAMAs. So I think there’s a lot of
CPD out there for SQP/RAMAs now, which is great. And there’s lots of online CPD too, which is even easier.

But a lot of it’s around the regulations, isn’t it? And I wondered whether it’s a good idea to have some training around managing the dispensary because that’s such an important part I think of an SQP Rama’s role whether it be in veterinary practice or in a pet store or a farmer’s merchants.

So would you agree that that’s a useful thing for SQPs to do? Melissa, what do you think?

Melissa:
Yes, I do agree. I think the CPD that is out there at the moment on the regulations is a good thing because obviously there has been so many updates recently and there’s been a change within the VMR. So I do think it is important.

But in terms of dispensary and medicines, I do feel like there is a gap, especially for SQPs and RAMAs, of what good looks like.
And I think there is so much CPD out there, which is fantastic.

And a lot of it is product led. So I do think that having what good looks like and having it like good examples of different RQP elements as well. So something that would happen in a vet
would be very different to a pet shop and to a pharmacist. So I do think that there is a gap there and an opportunity that is being missed.

Pam Mosedale:
Absolutely and whether it be a vets or a pet shop or a farmers merchants I think it’s still important to have systems don’t you that there’s no you can’t just kind of run the dispensary in an ad hoc manner there’s got to be systems like training and protocols and things so do you think making this more obvious maybe to ask you please and having some CPD around these systems is a good idea Stacey?

Stacey Bullock:
Absolutely. Yeah, I think without a doubt, really. I wish there was more. When I was a student, you know, and trainer, nobody really tells you these things. You just kind of pick it up from observations. And, you know, if we’re going to mitigate risks and, you know, try and prevent things from happening in practice, then all the more reasons to have systems in place and whether that be really simple systems, broach marking or having checklists, naming a responsible person, you know, and then deputizing that.

I think absolutely it’s without doubt really that that is necessary in practice and should really appeal to all, I think.

Pam Mosedale:
Yeah, and when you say systems, people start to get a bit worried that it could be something really complicated, well put there that it is sometimes very, very simple things. And I know you have some sort of built in systems, don’t you, Melissa, around using checklists basically on electronic devices?

Melissa:
Yeah, we have quite a few different systems. So our distribution center has automatic systems. In our pet care centres, we have electronic devices and we have electronic checklists there. We also do pocket guides. So working in the training team, we also
help support SQP/Ramas in that element because it’s so important that when you are in that situation with a pet owner, we’re only human. Things are going to get missed, errors are going to be made. And I think just putting all that support in place will definitely help ease that process, not only for the customer and the pet owner, but also for that SQP. So having electronic devices is great.

It means that there is consistency, but there is room there for complacency. So people over time could get very reliant on these devices and it will just then start forming habits which may not necessarily be positive habits either.

Pam Mosedale:
No, absolutely. And if you’re working somewhere where they don’t have the electronic devices, there’s no reason you can’t use a paper checklist, is there, for the same purpose?

Stacey Bullock:
And I’m a firm believer in manual checks as well, whether that being dispensing against your stock order system or generally just checking your ins and outs and making sure that warehouses, your dispensary is working for you really.

So yeah, what if the machines break? What if they don’t work? I’m still a pen and paper girl.

Melissa:
Yeah, and I definitely say double checking. Double checking is definitely key. think you as much as machinery is taken over the world at the moment, I do feel that human element is definitely needed in animal health care. And I do feel that, like you say, a bit of paper is no harm to anybody. I just feel that, yeah, double checking, as long as it’s double checking or there’s somebody there that you can communicate with as well is definitely key.

Pam Mosedale:
The only problem can be with double checking sometimes again, a little bit like you said about the electronic devices, we can start to rely on it. And if the person who’s doing the double checking doesn’t actually do it properly, it’s kind of worse than not doing it, isn’t it?

So I think that comes down then to training, doesn’t it? And having someone in charge.

Stacey Bullock:
Yeah, certainly Melissa there saying about communication, you know that is key between the teams and identifying if anybody needs any training needs, you know, and specifying sort of whether that’s internal or external as well. know, seeking
advice externally if nobody internally can direct them to the right place of training.

Yeah, I think in terms of that, it’s around your errors piece as well. If you are picking up on errors, whether that is like you say, externally or internally, we have an exemptions team within our customer services. So communication there from all
different elements of the business really work together to make sure that those errors are reduced.

But also then, like you say, it comes back to training. So that is where I’m a firm believer that you should always set that example of what good looks like.

And I think until you know where those gaps are or where those errors are, then you know where to put the training. Otherwise, sometimes training is just for training sake and it can be far too much.

Pam Mosedale:
So some of these webinars we’re talking about on this course could be used as external training, but of course, like everything, they’d need to be applied. There’s never anything. It’d be lovely, it, to just pick off the shelf things that we can just
instantly use?  Well, they’re all there, but they’ve got to be applied in people’s own circumstances, haven’t they?

So the other thing is protocols as well. think it’s quite important to have protocols, isn’t it, in the dispensary because there’s legalities you have to follow and questions that have to be asked and things. So how do you check that your team are actually using these protocols properly?

Stacey Bullock:
So it comes down to auditing. Again, auditing can be as complicated or as easy as you like. You can go with numbers and get the figures of quantitative data, or you can look at qualitative, and that can be as simple as feedback from your members of staff and having buy-in from the staff as well. So when you’ve got SQPs in place that they followed, but that they actually believe that they’re right for them as well. And then,
asking everybody if they’re working, but actually doing some background into it, if they’re working or not. Making sure that really you might want to look at sort of the root cause analysis and see why things have happened.

So bring it back to any errors that have occurred or any mistakes or near misses that have occurred as well.

Pam Mosedale:
Yeah, my favourite thing, near misses, near misses are so important and I think anybody in any situation, it is a risk, you mentioned risk and both of you mentioned risk and it’s a risky business. We do it all the time, dispense medicines, actually, and sometimes without necessarily training people properly before they’re going in to do it, but it is a risky business. It’s very dangerous if you dispense the wrong medicine.

So I think it’s really important to have these protocols and things in place and to check them. Yeah, so when errors actually happen then, how would you deal with them?

Stacey Bullock:
There must absolutely not be a blame culture and trying to get to the bottom of it by involving all staff and trying to involve sort of not necessarily competencies, but just training and identifying if there’s any gaps there. then, second guessing your policies and your procedures. Are they working? Why haven’t they worked in this instance?

And most of the time it is human error, isn’t it? But yeah, it’s trying to get to the bottom of that without that blame culture.

Pam Mosedale:
Yeah, that’s really important, isn’t it? Because people won’t tell you the truth about what’s happened if they feel they’re going to, or may not, if they feel they’re going to be blamed.

So I think that’s really important that we get that over that we’re just going to try to find out. there are structures in place and we’ve got some knowledge of how to do this root cause analysis and how to look at all the contributory factors because it’s rarely just a human error, is it? We put it down to human error, but it’s rarely just a human error. So, Melissa, you were going to say to join in there.

Melissa:
Yeah, it’s just it’s finding out why these errors occur as well. I know you’ve mentioned about training, but it could be confidence. So especially with SQPs, if they’re newly qualified, they’re going into this massive wide world of animal medicine.

And until you experience those scenarios, until you actually put yourself in those shoes, there’s not a one size fits all kind of scenario at all. Whether you’re just a CSQP or you’re an
RSQP, any situation is different. And I think nothing can prepare you for that.

There’s no CPD. It’s your life experiences. And I think, yes, you can share hints and tips from different RQPs across the industry. But I do think confidence is a really big element there.

Pam Mosedale:
No, I agree, but don’t you think standing back and thinking what might happen and thinking what you would do if it does happen can mean that in that situation it doesn’t deteriorate into that blame culture and you do learn from it.

Melissa:
Definitely, definitely. You only learn sometimes by making mistakes. Good mistakes.

Pam Mosedale:
That’s right. And you said about putting training and things in place. But I think putting systems in place is also super important because you can train people endlessly and sometimes people don’t necessarily listen. But also do you think it’s important that they’re involved in drawing the protocols up so they know what’s happening?

Stacey Bullock:
Yeah, I think it’s, you know, it’s a reflective practice really and you know learning from mistakes and looking ahead. And I mean you’ve got knowledge at our fingertips in terms of initial training and you know we’ve got the guides available whether it be BSA, VSA, VMD you’ve got plenty of things but it’s putting all that together, drawing it together and putting it into practice for your practice you know everybody’s practice is different and actually is it fit for purpose in your practice so yeah it’s having those discussions and finding the right thing for you.

Melissa:
I think it’s also about, it’s not just one person that’s responsible, it’s everybody’s responsibility. And I think that I know it’s been talked about where you have one person that is responsible and keeps an eye on everything, but I think it’s everybody’s responsibility because you all have an action, you all have a role to play.

And like you say, it’s not just one person to be blamed. It could be a protocol that someone’s put in place. It could be there’s so many different factors to it, but I think we all have to take
responsibility and take ownership of that and just learn from that error or mistake and move forward with it, whether that’s re-evaluating those protocols and systems or whatever it needs to be.

Pam Mosedale:
You’re absolutely right, it’s a whole team effort, isn’t it? It’s good to have one person who makes sure the team are trained and keeps an eye on the protocols and updates them when things change in the VMR or whatever, but it’s a whole team activity, absolutely.

Melissa:
Definitely. And I think with SQPs, we always say with our business, SQPs, retail store managers, and we’re quite fortunate that we have that practices within most of our
pet care centres as well. So we can even confer with other SQPs.

And I think that having that communication and those relationships really works really well and leading the way and setting that example from the top really will then drip feed down as well.

Pam Mosedale:
Yeah, no, I agree. It’s in any circumstance and anyone who’s working maybe in a small business which doesn’t have access to just some of the maybe doesn’t have access to other RQPs or doesn’t have access to some of your training, then making a
start could be looking at some of some of the resources maybe.

I’m just going back to what Stacey mentioned earlier about the near misses. I think the other reason that near misses are so useful is that you don’t get that worry because nothing actually did go wrong. So managing to discuss those and they’re a good way to practice, aren’t they, doing these things.

Stacey Bullock:
Yeah, that comes with confidence as well, doesn’t it? You know, we had this near miss, we identified it and this is what could have happened, but look, we’ve got these things in place. So, you know, we’ve mitigated that risk.

Pam Mosedale:
learning from everything that happens isn’t it good, bad and anywhere in between as well. And Stacey you mentioned reflection and I think that’s quite important from the point of view of this CPD isn’t it?

Stacey Bullock:
Yeah, I think, you you can’t learn from your mistakes, as we’ve said plenty times, you know, and I think you can’t go forward without reflection and, you know, what worked and what didn’t work, why, asking yourself these questions and also, you know, identifying do I need further training? Does somebody else need further training? Do we need to scrap that policy and, you know, draw back from the beginning? You know, be confident to do those things rather than just adding another step.

Pam Mosedale:
This CPD it’s not where you get automatic points, I think reflecting on it is the way to get your AMTRA points as well but I think that’s great because I think without reflecting on it and applying it to your own circumstance it wouldn’t be as useful.

So what would you say to SQPs, I’ll ask both of you this, what would you say to SQP/RAMAs who might be thinking of looking at this CPD around running the dispense rate?

Stacey Bullock:
I would certainly recommend that it’s invaluable and whether you just pick up a couple of things or you come away with a handful of ideas and you’re inspired to put it into your own practice, say absolutely put it on your to-do list.

Melissa:
I agree. It’s definitely on the to-do list after doing a lot of CPD myself. think this, I took a lot of elements away from this CPD and it was a great refresher as well as taking away elements that you won’t find in other CPD as well. I think, yeah, definitely, definitely put on your to-do list and you won’t regret it.

Pam Mosedale:
Thank you both very much. That’s been amazing chatting to you this morning. Thank you.

Stacey Bullock:
Thank you.

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