When it comes to health-system pharmacy practice, few in the profession have achieved a level of achievement on par with Patricia C. Kienle, MPA, FASHP. During her more than 35 years in pharmacy, Kienle has made countless contributions to medication safety, accreditation and regulatory compliance.
She is a member of the USP Expert Committee on Compounding, and is chair of its Subcommittee and Expert Panel on Hazardous Drugs. She is the author of Compounding Sterile Preparations: ASHP’s Visual Guide to Chapter <797> and co-author of Assuring Continuous Compliance with Joint Commission Standards: A Pharmacy Guide, 8th edition. Her list of contributions to health-system pharmacy is too extensive to list here – but the impact of her commitment to the profession is recognized nationwide.
Kienle was recently named by the American Society of Health-System Pharmacists (ASHP)’s board of directors as the recipient of the 2014 ASHP Award for Distinguished Leadership in Health-System Pharmacy Practice, which recognizes pharmacists who have achieved excellence in health-system pharmacy practice leadership through a record of leading sustained, progressive improvements in pharmacy services.
Here, Kienle, who serves as Cardinal Health's director of Accreditation and Medication Safety, shares her perspective of how health-system pharmacy has changed through the years; and what she sees on the profession's horizon.
Q: You've been working with hospital pharmacies for several decades. How would you characterize the changes you've seen in hospital pharmacy during that time?
A: There have been tremendous changes in pharmacy over the past several decades. When I started as a new graduate, hospital pharmacy was just emerging ‘from the basement.’ I worked with a wonderful group of pharmacists and techs at Mercy Hospital in Wilkes-Barre, Pennsylvania. The collegial relationship among pharmacy, nursing, physicians and others pushed pharmacy practice ahead of what others were doing. Fortunately, that attitude has become the norm. Clinicians are now educated together, so the silos of the past are breaking down.
For example, now pharmacists can get to practice at a higher level because we have technicians supporting core pharmacy functions. Technology has reached a point of making our work more integrated. All this points to pharmacy – pharmacists and technicians and the resources that support us – becoming a strategic asset to health-systems.
Q: You’ve accomplished a great deal during your time working in the hospital pharmacy world. What has kept you so committed to the profession?
A: The pharmacy school I went to (the University of the Sciences’ Philadelphia College of Pharmacy) produced many leaders in the profession. It was something that was ingrained to us – we were educated to practice at the highest level possible, and to have the responsibility to lead others. I am amazed at the number of pharmacy leaders who have graduated from the same school, influenced by the same professors. Pharmacy organizational efforts weren’t seen as something you might do, but something you were expected to actively participate in.
That’s why I became active in my local and state pharmacy organizations from the time I was a student. Networking with pharmacy leaders produces future leaders. We have talented pharmacy leaders at Cardinal Health who I similarly encourage to actively participate in local, state, and national pharmacy organizations. That is one way we can demonstrate our leadership.
Q: What do you see as the two or three most significant medication safety challenges hospitals will face in the next 5-10 years?
A: Integration of health records has the potential to allow much smoother – and safer – care for patients. But we have to find some way to protect privacy while allowing access to multiple clinicians in multiple sites. Academic medical centers and health plans have the infrastructure to do that, but we need to be sure that community-based practice models can also access the records they need to provide care to patients.
The explosion of new medications and medication-related devices will continue. We have to be prepared to adjust our practice as the need arises. There are still pharmacists holding onto roles that could best be done by others, freeing resources so we can adjust to being the medication use experts in all practice sites – not just acute care practice. Ambulatory care is an area where we need to focus.
All of this points to the need for scientific-based medication safety officers in many practice areas. Pharmacists are the professionals who are most educated and most appropriate to fill that role.
Q: What do you see as the major accreditation challenges hospital pharmacists will face in the next 5-10 years?
A: Medication management is a system-wide focus. Joint Commission – one of the four accreditation organizations that accredit hospitals in the US – just released a Patient Safety Systems chapter.It’s intended to guide organizations to have a comprehensive safety culture and approach. Medication use is a big focus in the safety arena.
Pharmacy’s efforts to attain federal provider status for pharmacists is another big issue from a business model need. We need this to be able to independently bill for services.
Q: Given all these challenges, where do you suggest hospital pharmacists start? How can hospital pharmacists lay the groundwork for these important changes?
A: Read ASHP’s Pharmacy Practice Model Initiative and work to implement those elements into practice at your organization. Effectively push new practice issues. Participate in pharmacy organizations. Work as a team.
Q: What’s the single most important piece of advice you’d offer to hospital pharmacy leaders in the coming year?
A: Stay focused on patient needs. Sometimes we get so wrapped up in a swirl of issues, we lose focus on why we are really here: to provide the best care we can, and continue to advance pharmacy’s role in healthcare.