The case for alternate pharmacy staffing models

Now more than ever, the hospital pharmacy is at a crossroads — needing to evolve its operating model to meet demands for new services and programs in a changing landscape. Particularly as the 2020 outbreak of coronavirus continues to impact the practice of pharmacy.

My previous Essential Insights article highlighted how the drivers of change in the healthcare industry are challenging hospital pharmacies with increasing demands to implement and manage new and expanded services. More often than not, pharmacy leadership is unable to add additional staff to meet demands due to cost constraints. This is a near-universal problem that we encounter with most hospital pharmacy leaders that we speak with, many of whom are also concerned with consequential employee burnout, affected quality and patient safety, compliance concerns, impacted service levels, increased overtime costs and more.

There are multiple guiding questions that pharmacy leadership should consider as they re-examine existing workflow and operations:

• When was the workflow and staffing model last assessed/updated?
• What new initiatives is the pharmacy supporting now or is planning in the near future that were not in place three to five years ago?
• Have new initiatives impacted the pharmacy staff’s ability to be more directly involved in patient care activities?
• Have new initiatives impacted your existing operations’ capacity to meet existing service levels in providing timely medication order processing and documented clinical interventions?
• When was the last time you measured nursing satisfaction?
• Are special projects on the horizon that will consume significant pharmacy time?
• When was your hospital pharmacy's emergency preparedness plan last updated? Would your pharmacy staffing and service levels be protected in another pandemic?
• Is the pharmacy having issues retaining or recruiting employees?
• Are there any infrastructure and/or technology upgrades on the horizon that will impact your pharmacy staff?
• Have you implemented or evaluated a retail pharmacy program? If not, what is preventing you from doing so?
• What new programs or services would you like to introduce but cannot given current staffing constraints?

The next step is to determine which model best suits your needs.

First, review your service levels and ability to support programs during periods that typically limit your team’s productivity and performance, such as:

• After-hours and weekend coverage
• Holiday coverage, vacations, sick time and temporary leave
• Daytime productivity during peak-volume hours, patient rounding and committee meetings
• Implementation of technology projects

Second, consider what your existing staff could accomplish during these periods with supplemental resources where you most need them. Create a business case for new models by estimating and documenting cost savings and revenue opportunities that you could realize with the execution of additional clinical programs, reduced readmission rates, improved HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores and implementation of a retail strategy. These estimates will help you carefully weigh the business case for change.

Lastly, talk to your peers and research the models available that you may have not yet considered. For example, could off-site resources carry the burden of routine medication order reviews, allowing your on-site team to focus on clinical programs, patient rounds, data analytics on program savings, medication reconciliation, discharge counseling and more? There are a number of new off-site resource models with flexibility to customize support around your pharmacy’s specific productivity challenges.