Editor's note: This article was updated on June 8, 2020.
Amid the backdrop of shifts in care settings, changing reimbursement criteria and intense cost control scrutiny, the hospital pharmacy is at a crossroads. It must adapt to expand the pharmacy’s reach and fulfill the pharmacist’s role as a pivotal provider of patient-centric healthcare. Traditional pharmacy workflows and operating models are stretched beyond their limits in this environment, taking their toll on employee satisfaction and burnout, as well as performance.
As the industry changes, the pressure on pharmacies continues to grow. Medications are the common patient touchpoint across all care settings, impacting so many areas of industry change: outcomes, readmissions, costs and reimbursements. And because pharmacists are essential members of the patient’s healthcare team, their availability, counseling and education services are important to delivering quality care.
The role of hospital pharmacy is rapidly changing in three significant ways:
1. The role of medication adherence in reducing 30-day readmissions
Reducing 30-day readmissions simultaneously improves reimbursements and patient outcomes. One of the most effective ways a hospital or health system can prevent readmissions is by ensuring medication adherence — and therefore, better patient outcomes — after the patient leaves the hospital. The pharmacist is in a unique role to help drive medication adherence through programs like medication reconciliation, meds-to-beds and patient counseling services. After all, the pharmacist is the one provider who can best ensure that patients understand their medications and counsel them on how to take their medications correctly post-discharge.
2. Pharmacy as a catalyst for clinical change
Other hospital-wide clinical initiatives to improve outcomes and control costs also demand pharmacy support and leadership. Regulatory bodies make some of these initiatives mandatory, such as antimicrobial stewardship programs. Pharmacy is the liaison between the infectious disease committee and the pharmacy and therapeutics committee and is tasked with reducing resistance and ensuring optimal medication therapy. The research, analytics and reporting required for a stewardship initiative are time-consuming and often require dedicated pharmacy staff to launch and maintain a successful program.
3. Expanding pharmacy care into the community
In response to shifts in care settings and the need to maximize reimbursements and create additional sources of revenue, hospitals and health systems are turning to pharmacy leaders to develop and implement a retail strategy. This can be complex and introduce challenges that the inpatient pharmacy is not familiar with addressing, such as acclimating to different inventory practices, financial operations, payer contracts, reimbursements and more. In many ways, the hospital pharmacy leader must learn a new business model and implement new workflows to support a seamless transition of care for patients.
Impacts of pharmacy demands
These expanded pharmacy services and programs are vital to a hospital’s growth and ability to thrive; however, due to the same cost-control scrutiny that drives them, the pharmacy often doesn’t have the ability to simply add staff to implement these initiatives. We find that many hospitals have had the same staffing models in place for years, despite the need to now support expanded pharmacy services. If pharmacy staff is already under pressure and showing signs of burnout — being under-resourced, overseeing temporary staffing and/or experiencing lagging service levels — it’s difficult for them to successfully execute and maintain these new services and programs.
New approaches to pharmacy staffing
Newer approaches to alternate staffing models supplement onsite pharmacy staff without adding new positions, introducing gaps in quality from temporary staffing or causing a drain on employee engagement from being pulled in many directions. Hospital pharmacy leaders should carefully evaluate their pharmacy workflows, especially if they haven’t been assessed in recent years, to learn how alternative pharmacy staffing models can be a cost-effective approach to successfully execute many of these new initiatives.
To learn about how other health systems are modernizing their pharmacy operations through alternate staffing models, view this recorded webinar. To learn what questions you should be asking and what type of model would best redeploy your pharmacy employees to strategic initiatives, read my next article in this series.