If you recently returned from the ASHP Midyear conference in New Orleans, hopefully you came away with new ideas to benefit your practice, hone your processes, and enable positive change. In many ways, these concepts can come to fruition through hard work and open communication, but perhaps the most important aspect of process change is focusing on what the issues are today, while considering how they will evolve down the road.
Consider the concept of drug diversion. The focus for many years has been on securing narcotics and other controlled substances, keeping them safe, and preventing staff, patients, or visitors from stealing, abusing, or selling these products in the community. While the cost of property loss is always a concern, diversion has mainly been viewed as a risk management, patient safety, and public health concern. But what has changed about diversion over the last three or four years? The sustained increase in critical drug shortages has altered the landscape of medication management such that many drugs—particularly high-cost products—have become illicit assets. Thus, the focus on diversion has evolved. Now, an enterprising staff member may no longer be looking to divert fentanyl to abuse, but might target an expensive chemotherapy drug that is on shortage or perhaps a performance enhancing drug. Selling these products can reap significant monetary gains and an unscrupulous employee can re-enter them into the grey market to price gouge other, unwitting hospitals that are desperate for them. Should you have the same mechanisms in place to cover your expensive drugs or those entering a shortage as you do for controlled medications? How do you identify drugs that require an additional level of oversight?
This is just one example of how broader influences outside of your control, such as shortages, can affect your processes, and these encroaching influences have to be taken into account. As pharmacy directors, making every effort to keep your eye on the ever-shifting focus of pharmacy practice is your primary charge. As always, PP&P will be there to help train that focus.
All the best,
R. Mitchell Halvorsen
P.S. PP&P would like to congratulate two members of our Editorial Advisory board for their respective awards recognized at the 2011 ASHP Midyear in New Orleans!
• The ASHP 2011 Distinguished Service award winner for the Inpatient Care Practitioners section was Deb Saine, MS, RPh, FASHP, medication safety manager at the Winchester Medical Center in Winchester, Virginia. The ASHP Pharmacy Practice Sections Distinguished Service Award recognizes a member from each section whose volunteer activities supported the mission of that section and helped advance the profession.
• Also, Stephen F. Eckel, PharmD, MHA, BCPS, FAPhA, FASHP, represented his colleagues at University of North Carolina Hospitals in accepting a 2011 ASHP Best Practices Award in Health-System Pharmacy for their research poster—Development, Implementation, and Impact of a Comprehensive, Medical Service Based Pharmacy Practice Model that Maximizes Pharmacist Involvement in the Patient Care Setting. This was one of six award-winning programs featuring best practices in health-system pharmacy, especially in those areas that significantly improve the quality of patient care.