Jeroen van de Pol

12 Chapter 1 Sense of urgency A sense of urgency needs to be present to motivate different stakeholders into actually agreeing on the necessity of change and starting the change process. Kotter states that a sense of urgency can be created through a bold, aspirational opportunity statement [25]. A sense of urgency was created by the 2006 HARM-report regarding hospital admissions related to medication. Results from this report stated that 2.4% of all hospital admissions and 5.6% of emergency hospital admissions were related to medication. A total of 46% of these admissions were deemed potentially avoidable. The estimated costs associated with these potentially avoidable admissions was estimated around 85 million Euros per year [26]. Similar conclusions were presented in a review article, which stated that one out of 10 hospital admissions are due to adverse drug reactions and that in most cases these were considered preventable [27]. Other research concluded that the contribution of community pharmacists within all these fields contribute to a better an sustainable healthcare system [28]. Stakeholders suchas healthcare insurers andgovernmental bodies are increasingly aware of the potential added value that community pharmacy practice can have when focusing primarily on the provision of CPS and the role community pharmacists can have within the healthcare system that is ever increasing in complexity and costs. All over the world the burden on healthcare systems is ever increasing [29, 30]. Reasons are the ageing population with increasing numbers of chronic conditions and increased healthcare demand. Innovative medical technology including medicines and shortages of healthcare providers further increase healthcare costs. And whereas new technologies further extent life expectancy, this also further increases the financial burden on the healthcare system [31]. See Figure 4 for a brief overview of the increasing Dutch healthcare costs over the years.