Program Summary

What is the objective of the Bloom Program?

For community pharmacists to help improve the health and quality of life of people with mental health and addictions problems living in Nova Scotia. This program aligns with the Province’s mental health strategy – Together We Can.

How will this be achieved?

People living with a mental illness and/or addiction with medication-related needs will receive enhanced services from their local community pharmacist, including

  • comprehensive consultations reviewing their physical and mental health conditions and medications,
  • greater collaboration among health providers,
  • regular patient-centred longitudinal follow-up care, and
  • support, resource and service navigation, and referral as needed

Pharmacies involved in the Bloom Program will support their communities by providing a mental health and addictions resource centre highlighting local supports, resources, and services. In addition, pharmacies will work with their local mental health and addictions communities to provide outreach education.

Who is eligible?

Patients

The overall target population is people living with an addiction and/or mental illness that is causing functional impairment who are prescribed one or more psychotropic medications. Pharmacies can register up to 20 patients at any one time, with 70% (14) of those patients having a higher priority diagnosis e.g. schizophrenia or bipolar disorder and 30% (6) having a lower priority diagnosis such as sleep disorder. The ultimate goal is recovery and discharge from the Program, normally after 6 months, but patients may stay longer if needed.

Pharmacies

Across rural and urban Nova Scotia selected pharmacies meeting a rigorous set of preparedness and quality standards are eligible to enrol patients into this program. To be eligible to participate pharmacies must:

  1. Complete an environmental scan of local mental health resources
  2. Establish & maintain links to support/advocacy groups and with local primary care and mental health providers
  3. Disseminate materials and advertise about the program
  4. Complete pharmacist and pharmacy staff training, and
  5. Establish internal record keeping and communication procedures

The Bloom Program is trialing a capitation reimbursement system, a novel funding model for these pharmacy services.

Why community pharmacists?

  • Locations & infrastructure: located throughout the province including rural and remote locations
  • Accessibility: more accessible than any other health care provider
  • Health professionals: regulated self-governing health professional body; bound by principles of health ethics; trusted
  • Education & training: pharmacists receive extensive education in health & illness (physical, mental), disease prevention, patient assessment, patient care, patient safety, medication effectiveness & safety, communications with patients and colleagues, documentation, the determinants of health, and the health system. Pharmacists involved in the Bloom Program are ready and eager to more formally collaborate with people with lived experience of mental illness and addiction, advocacy groups, and the formal health care system.

Who benefits?

People with lived experience of mental illness and addictions and their families are expected to benefit from this program. A formal evaluation jointly coordinated by Dalhousie University researchers, the Nova Scotia Health Research Foundation, and the Department of Health and Wellness will determine the program’s impact on patient outcomes, the community, the provision of health services, and on health costs.

How will quality be assured?

At a minimum, participating Bloom pharmacies and pharmacists will be expected to meet and implement the Nova Scotia College of Pharmacist’s Standards of Practice. A priority for this program is the quality of the service provided by participating pharmacists and pharmacies. Quality will be measured to ensure that pharmacists are providing satisfactory services and care as set out by the program. The program’s quality assurance activities include audits, site visits, simulated patient visits, and eligibility renewal applications. Routine quality assurance activities will be managed by the Program administrator who will work under the guidance of the Bloom Program Steering Committee. This multi-disciplinary committee’s primary role is to govern and oversee the strategic direction of the program. The Committee is accountable to the Department of Health and Wellness through the Special Advisor to the Associate Deputy Minister on Mental Health and Addictions.

When did the Program start?

The Bloom Program demonstration project will run through 2014-15 at 20 pharmacies in Nova Scotia. The first wave of participating pharmacies began patient enrolment in September 2014.