The alphabet of pharmacy challenges, solutions


Just what helps a health-system leader sleep at night? It isn’t counting sheep. It is going through the alphabet of pharmacy challenges and finding solutions.

A for advocacy, B for budget

Advocacy is necessary both internally and externally to your department’s success. All too often, we get tunnel vision and focus on the issue at hand or day-to-day operations. Communicating interdepartmentally within your health system and finding ways to share externally to your community can help pharmacy leverage its intrinsic value. Engage in outreach through case studies, articles, interviews, posters, and speaking engagements in both pharmacy and nonpharmacy venues. An annual report with an executive summary and supporting documentation can be just the tool you need to advocate by telling your department’s story and supporting the next challenge: budget.

Budget comes around annually, and pharmacy makes up, on average, 10% of the hospital’s entire budget. Among your most important budget tools is a monthly scorecard with productivity standards, metrics, and benchmarking tools to monitor and perform trend analysis. Monitor costs and work with finance to understand revenue capture and third-party contracts that provide reimbursement, in addition to using cost-saving programs such as 340B, patient assistance programs, and grants. Programs like these lead us to compliance.

C for compliance, D for diversion

Compliance and pharmacy have a longstanding history. Pharmacists are excellent “self-police” because they have a strong command of laws and are among the top-trusted professions. Pharmacy must be compliant with state and federal law, license requirements, and accreditation programs such as the Center for Pharmacy Practice Accreditation, Joint Commission, Healthcare Facilities Accreditation Program, and Det Norske Veritas. Pharmacy leaders must ensure that a management component includes compliance checklists, mock surveys, and working with internal and external compliance and audit experts. Without a solid compliance plan, the challenge of diversion comes into play.

Diversion comes in all shapes and sizes both in and outside of the pharmacy. Diversion is another way of saying “loss,” “shrink,” or “theft.” Be aware that diversion can occur in the health system wherever drugs are stored and in all areas of the health system—prescribing, administration, storage, and dispensing. Evaluate all points of entry and exit for inventory, and manage controls that monitor for unexpected activity. Put in place an antidiversion and loss-prevention plan, and include key departments in policies and procedures. With the evolution of technology, leaders should look at investments in inventory management reporting, payroll tracking, security systems, and external support to test and validate procedures.  

A good night’s rest is possible with your ABCs. Now catch some Zs!