The Winnipeg Regional Health Authority (WRHA) changed the governance structure for pharmacy services and integrated pharmacy staff from multiple acute and long-term care facilities into a single team under the direct authority of the WRHA Pharmacy Program. The governance structure now puts the drug distribution systems at all facilities under the direct oversight of pharmacy technician managers rather than pharmacist managers, and pharmacist clinical services (by client/patient care group) under the direction of pharmacist clinical managers; this clarifies the accountability framework for medication management changes going forward. The change in governance structure has enabled the development of a system-wide vision and strategy for medication management quality improvement initiatives rather than narrow (facility-by-facility) functional goals. It has also permitted refocusing of performance metrics on broad measures of the key elements of pharmaceutical care (e.g., pharmacist practice expectations).

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