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Published on Friday, September 8, 2023

An Open Letter to Pharmacists

When one sector of our profession is being attacked in the media, our entire profession’s credibility is undermined. As the voice of the profession, it’s APhA’s responsibility to address these issues directly.

Recently, several news outlets have published stories about pharmacist dispensing errors. While the incidents reported are tragic, the fact is that people make errors when systems do not fully support the individuals responsible for providing care. This is true throughout health care.

To improve systems, however, it is critical that a just culture be in place to ensure that pharmacists, pharmacy technicians, and all personnel involved in the process of medication use can anonymously report errors without fear of retribution and be empowered to institute changes to ensure those errors do not happen in the future.

There is no cover-up, as some news outlets report. Patient-specific information must be kept confidential per federal law. Additionally, in a just culture that encourages anonymous error reports, individuals shouldn’t be punished for unintentional errors that happen, nor should organizations be punished. These are teachable moments to implement systems changes to improve care and reduce or eliminate errors, and focusing on punishment and individual blame discourages that.

Patient Safety Organizations (PSOs) exist as an independent mechanism for error reporting and reduction strategies across health care. Every major chain pharmacy organization and most health systems in America partner with a PSO with intention to address these concerns. It is vital that pharmacies utilize the same just culture principles that work throughout the rest of the health care system so that real change can happen.

Whether we are a frontline pharmacist, technician, or employer, we all want the same outcome: the right medicine, the right patient, the right dose–every time.

Pharmacists, let’s also speak candidly about the undercurrent issue that is at play here. Understaffing of pharmacies is a major problem. Negative stories in the media don’t help the issue – it becomes harder to recruit the best and brightest into our great profession. Truthfully, the work environment in most community pharmacies is not ideal or supportive of optimal patient care.

APhA is fully aware of this, and we are working very hard on these issues. Our board of trustees are practicing pharmacists across the span of health care settings, including community and hospital pharmacy, and including frontline pharmacists.

This problem is not new, and the solutions are complex. We know that it feels to many of you like nothing is happening, but something is happening. APhA is driving change. APhA’s workplace and well-being issues task force has issued recommendations and resources for the profession. Commitments have been made by large employers to make changes, and while change can’t happen fast enough, incremental change is happening. Since APhA began convening the profession together, we’ve seen most corporately owned pharmacies shorten shift requirements in areas where there are personnel shortages and implement technology solutions to reduce telephone time and dispensing touchpoints. At least one chain corporation has established a new policy to eliminate metrics for performance evaluations, and we are seeing improved pay for pharmacy team members in both the community and hospital sectors. APhA staff engages in regular discussions with the chain pharmacy organizations and with health systems about just culture reporting, staffing, expansion of the scope of pharmacy technicians, better integration of technology solutions into practice to reduce pharmacy dispensing workload, and more.

Unreasonable reimbursement for pharmaceuticals and lack of payment for pharmacists’ services are the single largest inhibitor of more rapid change, and thus APhA has made addressing payment issues a top legislative priority.

We work closely with the National Association of Boards of Pharmacy and our state pharmacy association partners to affect changes in laws and regulations at the state level which support just culture and optimal utilization of pharmacy technicians and technology so that pharmacists are freed up to provide direct patient care.

Patient safety is our profession’s primary focus. The right medicine, the right patient, the right dose. Ensuring appropriate medication therapy outcomes is our obligation as a profession.

APhA and the profession of pharmacy stand united in assuring that consumer confidence and trust in the patient care we provide as professionals remains strong. For every pharmacist. For all of pharmacy.

My very best,
Michael

Michael D. Hogue, PharmD, FAPhA, FNAP, FFIP
Executive Vice President and CEO
American Pharmacists Association

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