Wicked problems are those that are seemingly impossible to solve because of incomplete, contradictory, and changing requirements. They are complicated by interdependency with other problems so that the solving of one may reveal or worsen another. Wicked problems are often socially complex, as there are typically multiple stakeholders who have unique views, challenges, opinions, and goals regarding the problem. The term is used to convey resistance to both the problem and the solution – while there is no “right” or “wrong,” they are often seen and characterized as “good” or “bad." Some of the other key characteristics of a wicked problem include: there is no definitive conceptualization of the problem, there is no one-size-fits-all solution, every wicked problem is entirely unique, and wicked problems can be understood and experienced in different ways depending on the stakeholder’s relationship to the problem.
Pharmacy stakeholders in Canada and internationally have been grappling with addressing numerous problems impacting pharmacy practice. These have resulted in unrealized pharmacist potential in addressing patients' healthcare needs. Pharmacy regulators are receiving increasing reports from practitioners of worsening workplace conditions that are not conducive to meeting professional practice standards, while pharmacy employers cite issues of disengagement and waning professionalism. This may be characterized as increased failure to put patients' interests first and inconsistencies in pharmacists’ ability to bring their "professional best" to every patient encounter. As Canadian pharmacists attempt to use the full scope/extent of their knowledge and skills in their practice, the profession struggles to overcome workplace- and system-level barriers, including poor understanding of pharmacy practice scope and competing priorities. Concerns are also being voiced internationally regarding issues such as polypharmacy and inappropriate opiate prescribing which are significantly impacting patient care and health system sustainability. While forums such as the General Pharmaceutical Council "Professionalism under Pressure" seminar held in October 2016 are increasingly bringing together key stakeholder groups, asking similar questions, and producing action plans, the pharmacy profession has not yet established an effective response to address challenges and opportunities related to professional practice issues.
Recognizing the need for a new approach, the Nova Scotia College of Pharmacists (NSCP) initiated a National Summit on Wicked Problems in Community Pharmacy (“Summit”). The Summit was predicated on the belief that the profession’s collective ineffectiveness in tackling these problems may be the result of not fully exploring the contributing factors through the lens of evidence-based and behavioral science research findings. As such, the aim of the Summit is to better position the profession to develop a theoretically-sound foundation for cultivating a unified strategic approach to current challenges by: