Fred J Boyd 2007 Award - jppr

The Fred J Boyd Award established in 1978, is a prestigious 

award bestowed by SHPA to an individual of high professional 

ideals who has made an outstanding contribution to hospital 

pharmacy. The winner of the Fred J Boyd Award 2007 is Sue 

Alexander. 

Sue Alexander has dedicated herself to the profession of 

hospital pharmacy, demonstrating sustained, exemplary service. 

AWARDS 

Fred J Boyd Award 2007—Sue Alexander 

Sue Alexander recipient of the Fred J Boyd Award 2007 

Her contribution has been at both Territory and national level, 

consistent and unwavering over the past 30 years. Sue has 

been a visionary, a leader and an inspirational mentor to many. 

Sue has been a long serving Director of Pharmacy Services 

at the Canberra Hospital, and previously as Chief Pharmacist 

of the Royal Canberra Hospital. Under her leadership, best 

practice in hospital pharmacy has been delivered to the 

community of Canberra and surrounding districts. Through 

leading drug information and poison information services, in 

accordance with SHPA standards of practice and high quality 

aseptic and cytotoxic services, Sue and her departments have 

been at the forefront of hospital pharmacy practice. 

Sue has taught pharmacy students and pharmacists in both 

a formal and an informal capacity and has held various honorary 

academic titles for her contribution to teaching programs. She 

has been instrumental in seeing to fruition the establishment of a 

School of Pharmacy at the University of Canberra and has 

been a significant member of the Course Advisory Committee. 

Sue’s involvement in advisory committees and working 

groups has demonstrated her capacity to work beyond senior 

administration, notably her membership to the TGA Expert Panel 

on Pharmacy Changes and Highly Specialised Drugs Working 

Party. Sue has given 16 years of service to the SHPA Federal 

Council and has been a member of the ACT Branch Committee 

for nearly 30 years. As a Federal Councillor, she has been a 

key player in the improved advocacy for SHPA to various 

government and departmental agencies. Sue has also been 

involved with the ACT Pharmacy Board. 

Sue Alexander’s exemplary professionalism, contributions 

and commitment to hospital pharmacy make her a worthy 

recipient of the Fred J Boyd Award 2007. 

Australian Clinical Pharmacy Award 2007—Neil Cottrell 

UK and in Australia. He has worked in a clinical capacity at 

North Staffs Royal Infirmary, South Manchester University 

Hospitals NHS Trust, and Royal Brisbane Hospital and Royal 

Women’s Health Districts. Neil is an experienced and 

enthusiastic teacher, having been Honorary Clinical Lecturer, 

Department of Pharmacy Practice, University of Manchester 

and Conjoint Senior Lecturer, School of Pharmacy, University 

of Queensland. Neil is now Senior Lecturer, School of 

Pharmacy, University of Queensland, where he continues to 

inspire the pharmacists of the future. 

Neil is widely regarded for his expertise and his enthusiastic 

willingness to share his experience and insights, through 

conference presentations, workshops and seminars at local, 

state and federal levels, as well as internationally. Neil has been 

involved in numerous SHPA conferences. He convened the 

2003 Qld Branch Conference, chaired the scientific 

subcommittee of the 2005 Federal Conference and served on 

Neil Cottrell receiving the Australian Clinical Pharmacy Award 2007 

the organising committee of the 2002 Biennial Clinical 

from Sue Kirsa (SHPA Federal President) 

Conference. 

In 1997, SHPA established the Australian Clinical Pharmacy Neil has gained a reputation as an exceptional 

Award to recognise outstanding contribution in clinical pharmacy communicator at innumerable clinical and rural seminars. Neil 

practice. The importance of clinical pharmacy practice and the has contributed substantially to numerous publications reflecting 

contribution to practice and therapeutics knowledge are both his interests which include the role of the clinical pharmacist in 

encompassed in the award, and Neil Cottrell’s achievements heart failure management, medication safety and the evaluation 

comprise fine examples from both of these areas. 

of medication information from the consumer’s perspective. 

For over 25 years, Neil Cottrell has contributed to the Neil Cottrell’s dedication to the development of clinical 

practice of clinical pharmacy through education and research. pharmacy practice including contributions to practice, teaching 

Neil has a wealth of experience as a clinical pharmacist in the and research makes him a worthy recipient of the Australian 

Clinical Pharmacy Award 2007. 

314 

Journal of Pharmacy Practice and Research Volume 37, No. 4, 2007

GlaxoSmithKline Medal of Merit 2007—Rosemary Burke 

The GlaxoSmithKline Medal of Merit is awarded annually for 

outstanding service to Australian hospital pharmacy. For her 

significant contributions to hospital pharmacy and ongoing efforts 

to improve safety for patients, Rosemary Burke, Director of 

Pharmacy, Concord Hospital is the recipient of the 

GlaxoSmithKline Medal of Merit 2007. 

Rosemary has made an outstanding contribution to the 

practice of hospital pharmacy over many years. She has been 

active in education and training of pharmacists and graduates, 

in the workplace and the wider health community. Since 1997, 

Rosemary has actively contributed to the Pharmacy Board of 

NSW, not only participating in graduate review processes but 

also contributing a hospital pharmacy perspective to course 

structure revision and site evaluations for educational facilities. 

Rosemary has been a member of SHPA since 1988. 

Between 1996 and 2001, she was a member of the NSW 

Branch Committee and was Chair from 1997. Rosemary 

continues to provide advice to the Branch Committee and has 

been a member of the organising committees for the 4th SHPA 

Biennial Clinical Conference and the 28th Federal Conference. 

Since 2002, she has shared her knowledge and experience 

by leading the SHPA Medication Safety Committee of 

Specialty Practice. In her workplace she has demonstrated 

leadership by ensuring the appointment of an Area-Wide Quality 

Use of Medicines Pharmacist to coordinate action across a 

number of hospital facilities. She has also attracted some 

significant grants to progress multidisciplinary medication safety 

initiatives in her local environment led by hospital pharmacists. 

Since 1994, Rosemary has been a member of the NSW 

TAG and a member of the NSW TAG Management Committee 

since 2002. Rosemary has been a member of the NSW TAG 

Safer Medicines Group since its inception in 2004 and has 

participated in a number of key working groups. In 2005, she 

was a member of the NSW TAG Australian Advisory Panel 

for adaptation of the ISMP Medication Safety Self Assessment 

tools for use in Australian hospitals. Rosemary has also been a 

member of the Project Steering Committee for the NSW TAG 

Performance Indicator and Medication Safety Project which, 

during 2006 and 2007, has developed Indicators for Quality 

Use of Medicines in Australian hospitals. 

It is an honour and a privilege to accept the Fred J Boyd Award. 

I feel extremely humble to be among the many distinguished 

recipients of this and the Glaxo Medal of Merit and Clinical 

Pharmacy Awards. I recognise that there are many more 

deserving members who have given outstanding service to our 

profession and the Society in particular, and I hope your work 

and commitment will be duly recognised. It is a very proud 

moment for me. I wish to thank the members of the ACT 

Branch, in particular the Chairman, Andrew Matthews, who 

nominated me, and then with great determination and trickery, 

convinced me to accept the nomination. 

Sue Alexander, BPharm, Pharmacist, The Canberra Hospital, Garran, 

Australian Capital Territory 

Address for correspondence: Sue Alexander, Pharmacy Department, The 

Canberra Hospital, Garran ACT 2605, Australia 

E-mail: Susan.Alexander@act.gov.au 

Fred J Boyd Award Oration 

Susan Alexander 

Rosemary Burke recipient of the GlaxoSmithKline Medal of Merit 

2007 

Rosemary is currently collaborating with investigators to 

evaluate the impact of electronic medication management 

systems on work practices, pharmacy activities, medication 

errors and patient safety. Rosemary has been instrumental in 

engaging decision-makers in hospital and government to 

recognise the role of hospital pharmacists in realising the safety 

outcomes that electronic systems are expected to facilitate. 

The GlaxoSmithKline Medal of Merit Award for 2007 is 

awarded in recognition of Rosemary’s continuing achievements 

in supporting the development of hospital pharmacy. 

I would also like to thank the pharmacy staff at The 

Canberra Hospital and Neil Keen, the new Director of 

Pharmacy. He is one of our Federal Councillors and the 

Chairman of the SHPA Division of Education. I have had the 

luxury and support of Neil and the hospital to phase my 

retirement from The Canberra Hospital over the past year. 

While ostensibly I have been there to handover, and 

provide support and advice to Neil and the staff, I have also 

been able to indulge in my favourite job of working in the 

dispensary and directly looking after patients. It has probably 

been frustrating for the rest of the staff though. I often hear, 

‘Ask Sue, this phone’s for Sue, where’s Sue?’ and there I am 

at the pharmacy counter, talking to a patient, planning to meet 

up in Paris with one of our renal transplant patients who has 

been posted to the Embassy there, or talking to Richard (who 

prefers to be called Rachael), about his CD4 count and the 

latest movies. 

Journal of Pharmacy Practice and Research Volume 37, No. 4, 2007 315

Last week (coincidentally at the same time) two adult CF 

patients who have had lung transplants presented their S100 

prescriptions to me. I have known both of them since they 

were children in the 1970s, when I worked in the CF clinic at 

Royal Canberra Hospital as a paediatric pharmacist. I was 

thrilled to be able to take the time to talk to them both again. 

Needless to say, every day, I find it a thrill to work in the 

dispensary, not only because of contact with the patients, but 

because of being ‘hands-on’ again, working with a wonderful 

team of technicians and pharmacists and being able to mentor 

the graduates and students. 

Anyway, I have digressed from what I wanted to talk about 

today, which is not about succession planning (although I can 

highly recommend it), but about the changes I have experienced 

in the past 30 years of my career, and how SHPA has been 

there to guide and support me. 

Neil asked me a couple of weeks ago if there were 

computers when I started in Pharmacy. The answer was a 

resounding ‘no’. I was still using a slide-rule, let alone a 

calculator, when I did my final pharmacy exams in 1974. He 

followed on with the question ‘well, did you have self adhesive 

labels then?’ My answer was ‘yes’. We fed the roll through the 

typewriter to type our labels and they kept getting stuck on the 

roll, so you had to constantly pull the typewriter apart. In 1978, 

we did acquire an electric typewriter with a memory that stored 

information on a magnetic tape and improved the efficiency of 

typing labels (but you still needed two fingers). I seem to 

remember that this was about the time that we recruited our 

first dispensary assistant to type the labels for us. 

It is amazing to think we progressed from typewriters to 

the sophisticated computer systems we have now, in just 20 

years. In 1985, the Australian Journal of Hospital Pharmacy 

(AJHP) published an article called ‘Consideration of 

applications and financial benefits of computer systems in 

hospital pharmacy’, and indeed, the theme of the 1987 Federal 

Conference in Hobart was ‘Basics to Basic’ with a strong 

emphasis on computer applications and justification. An AJHP 

editorial in 1987, described the role of computerisation in the 

continuing development of hospital pharmacy practice. In the 

same year the SHPA guidelines for the implementation of 

computer systems in hospital pharmacy were published, and 

the early 90s saw a proliferation of articles on a variety of 

programs, mostly developed in-house, with applications 

involving discharge prescriptions, printing of dispensary and 

IV admixture labels, stock control and formulation of TPNs. 

We acquired our first computer system in 1990 following 

the principles set out in the SHPA document to guide our 

selection. It printed dispensing labels, kept patient histories, 

produced picking slips for imprest supplies, printed orders for 

suppliers and provided a range of reports on drug usage. 

It is interesting that just as we all widely discussed, 

published on, and looked to pharmacy systems in the 90s, the 

same thing is being repeated today with electronic prescribing 

and medication management systems. 

I don’t want to delve too much into the history of clinical 

pharmacy; however, I would like to say that my first job in 

1975 at the now non-existent Royal Canberra Hospital was as 

a ward pharmacist. Sure, our job involved replenishing the 

imprest stock and ward housekeeping, but we did review every 

chart every day (called treatment sheets then), primarily to 

identify and dispense the non-stock items. My boss then, Mrs 

Enid Barnes, was very progressive, and had already introduced 

a distribution system based on limited imprest stock and 

individual patient dispensing. It was a rudimentary review of 

the chart—we checked for legibility, completeness, drug 

316 

interactions and correct dosages, and that the nurses had 

administered all the doses. In 1975, the chart had no duplicate 

and we transposed the orders. I introduced one duplicate in 

1985 that went backwards and forwards from the pharmacy 

to the wards, five duplicates in 1991 and now we are back to 

no duplicates. The clinical pharmacist scans the original order 

directly into the dispensary from the ward. And might I say, 

what a great achievement for us to now have the same 

medication chart in every public hospital in Australia! 

As a ward pharmacist in 1975, we taught extensively in 

pharmacology and therapeutics, because nurse training in those 

days was hospital based, and we instilled into the nurses the 

principles of right patient, right drug, right dose, right time, and 

right route. I am not sure that their training in this regard is as 

good today. 

The SHPA Ward Pharmacy Action Committee (which was 

the precursor to the Specialty Practice Committee) was formed 

in 1976 to facilitate the interchange of experience and ideas. In 

1980, six clinical roles were defined for ward pharmacists in 

the Journal: evaluating drug therapy orders, noting potential 

problems relating to drug therapy and selecting parameters for 

monitoring, coordinating the collection of ADR reports, 

providing drug information and collecting drug usage statistics. 

In 1982, an Australia wide survey, which was published in the 

AJHP, showed that 60% of beds were covered by a ward 

pharmacist doing these jobs, albeit the average number of beds 

per pharmacist was 100, and the average time taken per bed 

was 2 to 3.9 minutes, 23% took less than 2 minutes. 

As ward pharmacists back then, we didn’t often talk to 

patients, charts were centralised at the nurses’ station so we 

didn’t really have a reason to go into their rooms. The shift 

from changing the terminology from ward to clinical pharmacist 

came with our increasing interaction with the patients during 

the 1980s and like other hospitals we changed to having the 

charts on the ends of the beds. The first SHPA policy guidelines 

for the practice of clinical pharmacy were published in 1986. 

This was the first document to define clinical pharmacy and list 

those activities required of a clinical pharmacist. 

Drug information developed as a specialty during the 1980s 

as a response to providing a depth of expertise to increasingly 

complex clinical questions. Canberra hosted the first drug 

information seminar when the Commonwealth’s National Drug 

Information Service was established in the late 1970s. We called 

the conference, ‘Alice in Wonderland’. In 1980, the Drug 

Information COSP was formed, minimum practice guidelines 

were published in 1983, and by the mid 1980s most major 

hospitals had established drug information centres. 

While talking about the establishment of drug information 

centres, I cannot miss mentioning the establishment of centralised 

IV admixture services in the late 70s. This is the specialty service 

to which I feel I have contributed the most in my career, and 

before becoming a Deputy Chief Pharmacist in 1980, was my 

area of specialty. In Canberra, under the stewardship of the 

great Mel Davis, the Parenteral Services Action Committee, 

with an oncology subgroup, was established in 1978. In 1979, 

we published on justifying and establishing IV additive services, 

published aseptic dispensing guidelines and conducted aseptic 

dispensing courses for pharmacists and technicians from around 

Australia. From 1977 to 1980, involvement of pharmacists in 

oncology services was a major growth area. Centralised 

cytotoxic reconstitution was first seen as a role for the IV additive 

service and became a major area of aseptic dispensing, but in 

1980, it was identified that this may not be without its problems 

and the occupational hazards were recognised. It was the 

Parenteral Services COSP based in Canberra that first published 


the guidelines for safe handling of cytotoxic drugs in pharmacy 

departments and hospital wards; they were updated in 1982 

to include the recommendation of using a laminar flow cytotoxic 

drug safety cabinet. 

Unfortunately, the 80s were also the era of economic 

rationalism, recurrent cost-containment measures, Booz-Allen 

reviews, and perceived fat trimming. We struggled to justify 

the costs of clinical pharmacists. In 1985, the year I was 

appointed as Chief Pharmacist, there were no fewer than eight 

articles published in the AJHP on clinical pharmacist workloads 

and activities, and the first costing study was published to 

demonstrate cost justification of clinical services. These surveys 

and activities, published and promoted by SHPA, assisted 

pharmacy managers to promote clinical pharmacy as part of a 

comprehensive pharmacy service. 

Chris Doecke, at the 1991 Federal Conference, heralded 

the path of clinical pharmacy in the 1990s by asking the 

question, ‘Why are we still talking about putting theory into 

practice after 20 years. We must move to measuring 

improvement in patient outcomes, ensuring the quality of our 

services, focus on appropriate drug use and collaborate in 

changing prescribing practices’. 

Quality Assurance, Total Quality Management, and Quality 

Use of Medicines thus became the themes of the late 80s and 

90s, focusing on not what we did, but what we achieved. Many 

initiatives were published and taken up to promote Quality Use 

of Medicines. In 1992, the Quality Assurance COSP published 

the first SHPA performance indicators and in 1996 Standards 

of Practice for Drug Usage Review were published. In 1993, 

pharmacoeconomics was the theme of the Sydney Federal 

Conference. There were many attempts, facilitated by SHPA, 

to train us in drug use economics, quality of life year assessments, 

decision analysis, pharmacoeconomic evaluations, and we tried 

to apply these principles to our drug and therapeutic committee 

decisions—in my case, a miserable failure. 

In the 90s we were called upon to provide evidence of 

the value of clinical pharmacy services. SHPA was unwavering 

in its support for pharmacy managers and in 1998 commissioned 

the clinical pharmacy intervention study demonstrating that 

routine review of patient drug therapy saves lives, improves 

patient care, reduces length of stay and saves money. Although, 

by the start of the new millennium, the quality and safety agenda 

had been taken up and clinical pharmacists were indelibly 

viewed as critical to safe medication practices, the study, finally 

published in 2003, confirmed the Safety and Quality Council’s 

view that the provision of clinical pharmacy services reduces 

medication incidents. 

This leads me to mention the overall health policy changes 

that have impacted over the past three decades on our ability 

to get on with saving lives. Although, I thought we did pretty 

well in the 70s (after all, it was before ACT self government 

and Royal Canberra Hospital was Commonwealth funded with 

what seemed like unlimited resources), the 1980s were times 

of constant change; curtailed staff levels, workload growth, 

oppressive financial restrictions, hospital closures (including my 

own, Royal Canberra Hospital) and amalgamations which led 

to major upheavals of pharmacy departments. In the 1990s, 

changing organisational structures in hospitals affected most 

pharmacies. Organisation restructuring was a feature of the 

1995 Federal Conference in Melbourne. There was much 

debate in the AJHP about whether we should join an allied 

health division. There were issues of power and politics, seeking 

of greater recognition and greater resource allocation. There 

was the emergence of alternatives to the functionally based 

divisional structures to product-focused or matrix structures, 

with decentralised management and devolvement of costs. 

We also had DRGs, clinical costings, cost weights and 

casemix funding to contend with in the 90s, SHPA again being 

heavily involved in supporting pharmacy managers with these 

new considerations. And thence to the jargon of the new century: 

clinical streaming, patient-centred care, service integration, 

organisational capability, clinical and corporate governance, 

stakeholders, benchmarking, accountability, clinical risk 

management, frameworks, clinical and non-clinical outputs, 

flexible models. I would like to quote from ACT Health’s current 

Quality and Safety Strategic Plan: ‘The clinical governance 

framework has been established to provide explicit lines of 

accountability with a clearly defined management structure that 

allows facilitation, coordination, monitoring, evaluation and 

feedback of the services provided, and is based on a set of 

guiding dimensions to quality and safety that are built around 

four key interlocked strategic areas; clinical competence, clinical 

effectiveness, clinical risk management and system enhancement 

and accountability’. Well, good luck Neil! 

My message in mentioning just a few of the changes that 

our profession has seen over the period of my career is in the 

following questions: How did I manage these changes? How 

was I able to adapt to change? How did I find the information 

and gain the knowledge and competence to facilitate such 

changes? How did I become informed and educated in order 

to progress and introduce new services? 

The answer is SHPA. SHPA provides us conferences, 

seminars, lectures, the Journal, the bulletin, COSPs, guidelines, 

position statements, grants and awards, and advocacy to name 

but a few things. It provides us with the opportunities to build 

awareness and an understanding of the current environment, 

for networking, for sharing experiences, disseminating 

information, making lifelong friends and contacts, for learning 

and providing the know-how to institute change, progress and 

improve. Or to quote from the current CPD program it keeps 

us current, informed and connected. 

My career was and still is, inextricably tied to being a 

member of and being involved with SHPA. I am proud to have 

served on Federal Council, the State Branch Committee and 

various COSPs and to be involved with educating and informing 

others. However, I can’t begin to say how valuable that 

involvement has been to my own career. Being so well informed 

through this involvement has meant that I have been able to 

facilitate change, develop, and improve the services in the 

hospitals that I have worked. 

SHPA provides the way that our profession communicates 

and informs; so I urge you to get involved, give back to SHPA 

some of what it has given you. I know this will be a hard 

concept to grasp for the members of the Y generation in the 

audience, but I urge you to think about, not what SHPA can 

do for you, but what you can do for it. 

In closing I would like to use the words of the late Pam 

Nieman when she accepted this award in 1995 (and she would 

be very upset about missing this Conference). ‘We owe a debt 

to our profession. It serves us well through our lifetime —so 

we must give back to it’. 

Thank you SHPA, which is all of you, for what you have 

done for me. 

Sue Alexander delivered her oration on 10 November 2007 

at the 28th SHPA Federal Conference in Sydney. 


318 

GlaxoSmithKline Medal of Merit Oration 

Rosemary Burke 

Firstly, I would like to thank the NSW Branch for nominating 

me, Federal Council for selecting me and GSK for sponsoring 

the award. I am honoured to receive it and feel quite humbled 

because peer recognition is the highest form of recognition. 

My background is of one who grew up with a father as a 

pharmacist and along with my sister and brothers: Sharon, 

Michael and Tony, spent many hours in Dad’s pharmacy at 

Riverwood in Sydney. We progressed from putting lids on 

bottles, to stamping repeat prescription pads and, finally, as 

we got older, to serving customers. Dad’s dispensary was a 

place of mystery and we loved watching him make up mixtures, 

creams and ointments. 

The first professional dictum I remember is ‘If in doubt 

throw it out’ which referred primarily to the extemporaneous 

side of pharmacy. He demanded that a quality product be 

produced that also looked like a quality product so that the 

patient would have confidence in what they were using or 

taking. If you had a doubt as to whether something was made 

correctly, perhaps because you were interrupted in the middle 

of manufacturing, you needed to rethink and start again. Safety 

was paramount. His other saying was ‘if in doubt check it 

out’ referring to that sixth sense most pharmacists have that 

something is not quite right and that knowing how to clarify a 

prescription and intervene was an important aspect of being 

a professional responsible pharmacist. Dad believed in a 

quality pharmacy service and always remembered the patient 

was at the centre of the practice of pharmacy. So from an age 

where I did not even know that being a pharmacist was to be 

my career path the two themes of patient safety and quality 

were already being ingrained. As I grew up the practice of 

pharmacy changed from a science of compatibilities and 

formulation to a communication profession. My practice is 

very different to my father’s and the practice of hospital 

pharmacy and the variety offered within it has also changed. 

I started in community pharmacy and later spent a short 

time teaching science in high schools (incidentally following in 

my mother’s footsteps who qualified as a teacher when I was 

finishing school). I, like many Australians, ventured overseas 

and became a backpacker pharmacist which was where I 

was first introduced to hospital pharmacy. 

When I returned to Australia I obtained a position at St 

George Hospital as a clinical pharmacist. The early definitions 

of clinical pharmacy are ‘at the bedside’ which does describe 

the practice of clinical ward pharmacy. It was later broadened 

into a definition that includes any practice site where 

pharmacists provide patient care that optimises the use of 

medication and promotes health, wellness, and disease 

prevention. This fits in well with Australia’s National Medicines 

Policy and Quality Use of Medicines which aims to ensure 

appropriate, judicious, safe and effective use of medicines. 

This is the core business of hospital pharmacists and those 

who work in our health system. 

Most pharmacists wish to practice in order to make a 

difference. In my days as a clinical ward pharmacist, I enjoyed 

Rosemary Burke, BPharm, Director of Pharmacy, Concord Hospital, Concord, 

New South Wales 

Address for correspondence: Rosemary Burke, Pharmacy Department, 

Concord Hospital, Concord NSW 2139, Australia 

E-mail: Rosemary.Burke@email.cs.nsw.gov.au 

the chance to intervene for a single patient in order to optimise 

their therapy, prevent an adverse reaction and counsel them 

about their medication use. I enjoyed practising patientcentred 

pharmacy whether it was in the dispensary or in the 

wards. The problem was that there was never enough time to 

do everything you wanted for everyone on the ward. You 

either gave a reasonable service to everyone or a quality 

service to a few. 

It was at St George and later at Prince Henry that I first 

started thinking about systems approaches to improvement 

that is what you could do for groups of patients at a time 

rather then focusing on the individual. We often think about 

systems approaches to the prevention of error, e.g. removal 

of potassium ampoules from the ward, moving to individual 

drawers for medication rather then trolleys and systematic 

approaches to dispensing. We need to broaden this focus so 

that there is a systems approach for all processes in order to 

improve and make things better for our patients and staff. 

Improvement can become a driver and change embraced 

rather then feared. This can involve the rethinking of various 

processes, not being too bound by the way we have always 

done things and looking at ways to redirect our resources to 

improve overall care. 

We do not practice in isolation but rather with other health 

professionals in a team environment. Often we need to work 

together to improve safety and quality. Interprofessional 

collaboration is one of the strengths of our practice. What is 

needed is not static nor is it an identical recipe for every hospital 

or practice setting. I have been the Director of Pharmacy at 

two hospitals: Wollongong and my current position at 

Concord. In both cases I was lucky to follow strong, capable 

and respected leaders in Margaret Duguid and Maria Kelly. 

While my role at both hospitals is in essence the same, the 

direction is slightly different. Wollongong Hospital is the largest 

hospital in the Illawarra region and at the time I was there it 

was described as being ‘on the road becoming a teaching 

hospital’. It had very close links with the local community, the 

Division of General Practice and the Illawarra Pharmacists 

Association. Furthering these links with the local community 

was a major focus of my time there. Although I was involved 

in many projects, the major achievement was setting up a 

community liaison pharmacy service which combined home 

visits and talks for multiple community interest groups. I was 

lucky enough to work alongside some wonderful pharmacists 

such as Margaret Jordan and Judy Mullan who have moved 

outside the hospital walls but still work to ensure the quality 

use of medicines. 

In contrast Concord is an established teaching hospital 

with a long tradition of service to the veteran community. But 

it had different priorities. The two areas I have been most 

involved with are medical handover (I co-chair the patient 

care committee) and electronic medication management. After 

five years of planning we finally went live on one ward last 

week. Once again I have worked with a multidisciplinary team 

of people where I have had to remember not to be too 

pharmacy centric but to look globally at what we want to 

achieve and how the needs of the patient can be best served. 

How can we improve the system while building in safety 

principles and encourage quality prescribing, administration 


and dispensing within the electronic environment? We need 

to be careful that some of the gains we have made in the 

paper world are reflected in the electronic world at the same 

time realising that it is a different paradigm and that making 

an electronic system mimic every current business practice is 

not always the answer. Even in the last seven days we have 

made a number of changes based on the experience of the 

users as theory and practice can be quite different. 

A systems approach requires analysis. Lucian Leape 

groups systems failures into design failures, i.e. design of the 

process, task or equipment and organisational failures related 

to conditions in the workplace, team building and training. 1 

What could be described as an excellent pharmacy service 

today will not fulfil the needs in 10 years time. To take 

pharmacy into the future we need to constantly look at ways 

of improving. This may involve changes to education, teaching 

and systems design. We can do this by: 

collecting and analysing data (from literature, conferences, 

our own data); 

disseminating information (via newsletters, the Journal, 

presentations within and outside the hospital); 

educating (doctors, nurses and patients through a variety 

of techniques); 

collaborating (within the hospital and outside in groups 

such as NSW TAG, and SHPA); 

conducting research (whether it is practice based or 

medication therapy based); and 

not settling for the status quo and embracing change 

opportunities. 

Australian Clinical Pharmacy Award Oration 

Neil Cottrell 

I would like to start by thanking George Taylor, Peter Fowler 

and their colleagues in the Tasmanian Branch of the SHPA 

who nominated me for this award. It was a great honour for 

me when I was approached by them. I would also like to 

thank the Federal Council who chose me to receive the Clinical 

Pharmacy Award for 2007. I have to confess that when Sue 

Kirsa informed me that I was to receive the award I was 

speechless. I felt then and still do feel very honoured and 

extremely humbled that my peers had thought me worthy to 

receive the Clinical Pharmacy Award. The bubble burst 

somewhat when Sue then kindly reminded me that I had been 

practising as a pharmacist for 25 years and that immediately 

brought me back to earth and I felt a lot older. 

I then realised that I would be giving an oration here at 

the Federal Conference where there would be an expectation 

that I would pass on words of wisdom about clinical 

pharmacy. I reflected on the previous recipients of this award 

and felt extremely nervous about what I had to offer in this 

context. Although I stand in front of an audience most days in 

my current role as a senior lecturer it is usually with 

PowerPoint as a prop in front of me not a written script. I tell 

my students that I don’t have a script with PowerPoint I make 

it up as I go along. Well not today. 

Neil Cottrell, BScPharm(Hons), MScPharm, PhD Candidate, Senior Lecturer, 

School of Pharmacy, The University of Queensland, St Lucia, Queensland 

Address for correspondence: Neil Cottrell, School of Pharmacy, The 

University of Queensland, St Lucia Qld 4072, Australia 

E-mail: n.cottrell@uq.edu.au 

You do not have to be a director of pharmacy to make 

systems changes and practice changes. At every level of 

practice whether we are pharmacists or technicians 

improvement should be a driver. 

Activities such as I have outlined are not one man projects 

and I have been very lucky to work with many wonderful 

people to help me over the years. I wish to acknowledge my 

staff, and the many wonderful pharmacists, technicians and 

other people I have come to know through work or SHPA 

activities. Special acknowledgement must go to Johneen 

Tierney, Karen Kaye, Liz Perks and Terry Maunsell who has 

been a mentor, a colleague and a friend. Finally, I need to 

acknowledge the support of my mother and father, brothers, 

sister and their families including my nephew and nieces where 

I am not seen as a pharmacist or an SHPA member but as 

Auntie Rosemary. 

I have tried to combine the two themes of quality use of 

medicines and medication safety in a constantly changing 

environment. We need to be aware of the changing 

environment in which we work and adjust our processes, our 

emphasis and activities to it. As William A Foster said, ‘Quality 

is never an accident, it is always the result of high intention, 

sincere effort, intelligent directions and skilful execution. It 

represents the wise choice of many alternatives’. 

Reference 

1. Leape L. A systems analysis approach to medical error. In: Cohen M, editor. 

Medication errors. Washington DC: American Pharmaceutical Association; 1999. 

Rosemary Burke delivered her oration on 11 November 

2007 at the 28th SHPA Federal Conference in Sydney. 

I thought that I would share some insights that I have 

gained in moving over to the university. I see my new role as 

one that tries to enrich, engage and instil into the students all 

about the marvellous profession and career that they are going 

to embark upon. 

But in sharing those insights with you I need to go back 

in time first. I am sure that you can all remember your first 

day as a pre-registration graduate and maybe even your first 

day on the wards. I can remember mine. Just take a moment 

to reflect back (I know some of you like me may find that a 

bit harder to do). That feeling of total inadequacy where I 

hoped no one would speak to me or even worse ask me a 

question. Nothing I seemed to have done at university could 

be remembered or had prepared me for the ward environment 

in a busy hospital. Yes hospitals were busy even in my day. 

However, I was incredibly fortunate to have some wonderful 

pharmacists around me who became mentors, role models 

and eventually colleagues. It was their patience, 

encouragement, nurturing and unselfish sharing of their 

knowledge that allowed me to grow as a clinical pharmacist, 

a professional and importantly as a person. In the UK, I would 

like to pay tribute to Geoff Bourne, Ray Fitzpatrick, Judy 

Cantrill and Jonathon Cooke (the last three of whom 

eventually became professors), I am forever indebted to them. 

But it didn’t stop there and when I traversed the world I was 

fortunate to meet the likes of Jeff Hughes, Chris Alderman, 

Deborah Rowett and of course I could not do this oration 

without mentioning my partner in crime, Ian Coombes, true 

role models for me still to aspire to. 


So where am I taking you with all this. I want you to 

consider the clinical pharmacists of tomorrow as these are 

the pharmacy students of today that I and my colleagues at 

the universities are preparing. You probably acknowledge as 

I do with some frustration that we produce graduates who on 

occasion seem to not know as much as you would expect. 

Now and again you probably curse the fact that the university 

has not taught them basic things; an example that springs to 

mind would be the dihydropyridine calcium blockers causing 

swollen ankles. I too, when I was in hospital practice, was 

confronted with this same issue. However, as I said earlier 

now I am in the university system I have been somewhat 

enlightened. You see we do teach this along with a lot more 

therapeutics. By the final year we have the students tackling 

quite complex integrated cases (which is really medicines 

review) with complex multiple pathology. However, there are 

two things that cause problems, one is the context (i.e. in a 

classroom and we can do something about that) and the other 

is the learning style. As a professional, as part of your 

commitment to continuing development, you adopt deep 

learning practices. This means that you critically analyse new 

ideas, and link them to previous concepts and knowledge 

which allows you to use them for complex problem solving. 

This is something you do every day in your role in resolving 

drug related problems for patients. Some students do display 

this, but unfortunately a significant number adopt surface 

learning. In this they accept new ideas without critical appraisal 

and store facts particularly those they feel or are told they will 

be assessed on. As a consequence they retain them for a 

short period, i.e. until after their exams and then they are 

forgotten and, further, they only use them in a disconnected 

manner. They are studying for their degree and not for their 

career or profession at this stage. 

We try and address this through our encouragement of 

what they can achieve in the future in their careers as a 

pharmacist. We try to facilitate a style of learning for them 

that will be lifelong. I should stress this does not mean that 

these are bad or unknowledgeable individuals. I was a surface 

learner at university and this is where I have come in a complete 

circle in my oration. Remember my earlier comment about 

my first visit to the wards ‘nothing I seemed to have done at 

university could be remembered or had prepared me for the 

ward environment’. However, I had fantastic role models and 

mentors to help me. 

The students often say to me how they look up to me 

and the other tutors as role models and mentors (interestingly 

always before the exams and never after —I don’t think there 

is anything significant in the timing of that). So this is your 

challenge—to help the clinical pharmacists of tomorrow. They 

will have high expectations of what they want to do and you 

are going to have to have patience, you are going to have to 

nurture them, be unselfish with your knowledge and time and 

finally become those role models and mentors which we all 

had which will result in them developing as clinical pharmacists, 

professionals and as people. 

I will leave you with those thoughts and comments as my 

script is at an end. Thank you. 

Neil Cottrell delivered his oration on 9 November 2007 at 

the 28th SHPA Federal Conference in Sydney. 

320

Fred J Boyd 2007 Award - jppr

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