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Pharmacy Specialty Networks

Application to form a CSHP joint PSN

In keeping with our values, CSHP established the Pharmacy Specialty Networks (PSNs) as a free benefit to our members.

The PSNs are created to promote practice excellence and the enhancement of patient‐centred pharmacy practice through information sharing, educational events, and the facilitation of research. Through the PSNs, CSHP members have a forum to network and communicate with other CSHP members who have similar interests in the areas of practice, education, research and/or management. The number of PSNs created continues to grow – this is a good indication of how much our members value the PSNs.

These PSNs can be shared with other organizations. All applications must be completed by the Executive Director of the organization requesting to form a CSHP Joint PSN. The submission of an application does not guarantee that the application will be accepted. Please refer to the Criteria for the Formation of a CSHP Joint PSN provided below

If a joint PSN with CSHP interests your organisation please complete the online application form provided below.

All enquiries related to this application should be forwarded to Rosemary Pantalone, PSN Administrator at rpantalone@cshp.ca.

Information about the organization:
Organization Name:
Mailing address:
City:
Province:
Postal Code:
Webpage URL:
Executive Director:
Email:
Telephone:
Mission of the organization:
Does the organization represent Canadian interests at the national level?	Yes No
Number of people employed by the organization:
Individual membership fees:
Current number of individual members:
Estimated percentage of members that are pharmacists	< 25%
	25 to 49%
	50 - 74%
	75 - 95%
	>95%
Number of members estimated to join the CSHP Joint PSN (if approved):

Name of CSHP PSN that the organization requests to join
Anticoagulation	Neurosciences
Cardiology	Paediatrics
Critical Care	Palliative Care
Drug Information	Parenteral
Drug Use Evaluation	Pharmacists-In-Training
Emergency Medicine	Pharmacy Informatics
Geriatrics	Primary Care
Global Health	Psychiatry
Home Care	Small Hospitals
Internal Medicine	Surgery
Infectious Diseases	Transplant
Medication Safety

Reasons for request
Describe how the organization’s members share the same interests as the members of the PSN:
Anticipated benefits to your members:
Anticipated benefits to CSHP members:

Criteria for the Formation of a CSHP Joint PSN

Requisite attributes of the Partnering Organization:

The partnering organization must be willing to support the Mission, Vision, and Values of CSHP.
The partnering organization must be Canadian and represent national interests.
Members of the partnering organization must share the same pharmacy specialty practice as that held by CSHP members in the PSN.
The majority of members of the partnering organization are preferably pharmacists that do not practice in a hospital setting or would not be eligible for an active level CSHP membership).
Members of the partnering organization pay an annual membership fee, preferably of at least $100.
The organization must have the infrastructure (preferably employees) to support the operations and requirements of maintaining a joint listserv (such as membership renewal information, possibly providing a Joint listserv and/or a Joint PSN webpage that is independent of both organizations’ webpages).

The Partnering Organization must agree:

to sign a Memorandum of Understanding regarding the operation of the Joint PSN. As a supplement to the CSHP PSN Handbooks, the agreement would describe the terms and conditions in which CSHP and the partnering organization jointly operate Joint PSNs for the advancement of pharmacy practice in Canada.This document will outline responsibilities of CSHP and the partnering organization with respect to operations, fiduciary responsibilities, shar ed responsibilities, PSN governance, designat ed liaisons of each organization, membership limits, applicable annual fees for service (in the absence of shar ed services or support from the partnering organization), and the proc edure to dissolve the Joint PSN. CSHP and the partnering organization will review this memorandum of understanding annually.
to not compromise the Objectives of the CSHP PSN.
to abide by the CSHP PSN Policies and Procedures, PSN Executive Handbook and the PSN Member Handbook.
to pay an annual “fee for service” charged by CSHP, unless CSHP and the partnering organization agree to share operational responsibilities and expenses. This fee for service could be either a fee per participant or annual maintenance fee.
to provide information on membership status at least annually, but ensure only current members of their organization are members of the Joint PSN.
to name a liaison to work with CSHP with respect to all discussions regarding the Joint PSN.
its members are not entitled to receive any CSHP membership benefits, other than those directly related to the Joint PSN. For instance, the joining organization’s members would be able to join the listserv group, but would not have access to password-protected information on CSHP’s website.
to limit its membership in the PSN to less than 50% of the Joint PSN membership.
a member of the partnering organization cannot chair the Joint PSN, but can hold the position of Co-Chair with a CSHP member as Co-Chair.
members of the partnering organization, as members of the Joint PSN will not participate in the procedure for PSN Endorsement of documents for CSHP. However, they may participate in the development of CSHP papers and official publications prepared by the Joint PSN at CSHP’s request and discretion. The extent of the participation may depend on many factors, including the purpose of the paper, or if the paper is a joint publication of CSHP and the partnering organization.