Transitions in pharmacy practice, part 3: Effecting change - the three-ring circus

The prerequisites for a change in practice in individual pharmacists, as framed by the Holland-Nimmo practice change model, are discussed. The Holland-Nimmo practice change model comprises three components, all of which must be addressed by a pharmacy's leadership if a change in practice is to be achieved. The first component is the practice environment, which must be conducive to implementation of the new form of practice. The second component is the availability of appropriate training for individual practitioners. The third component is an appropriate set of motivational strategies to be applied by the manager. All three components must be present at the same time; no one or two components by themselves are sufficient. The practice change model is equally applicable to pharmacy department managers in health-system settings and to community pharmacy owners and managers. To maximize the potential for individual pharmacists to change their practice, managers must create an environment conducive to the new form of practice, identify needed learning resources, and motivate practioners to change.