The role of pharmacy director requires acumen related to several, often disparate areas including pharmacology, supply chain, technology and automation systems, and personnel management. With this in mind, it is important to approach overall medication-use safety from a strategic perspective, because controlling and perfecting every aspect of medication management is simply untenable. Outside variables can and do impact patient and product safety and this assumption must be incorporated into safety planning.
Consider, for example, the management of chemotherapy functions from purchasing and acquiring medications to administering those drugs to a vulnerable patient population all the while maintaining rigorous safety standards. This is an area where dominos can quickly fall; the loading-dock worker who handles a broken box of hazardous drugs, the compounding pharmacist who does not think every step of aseptic technique is necessary, the nurse who is frustrated with a CSTD and so removes it prior to administering a medication. All these steps lead to exposure at the site and downstream, and one person’s mistake or lapse in protocol can jeopardize the safety of innumerable populations including other patients, staff, and visitors. As a pharmacy director, you should expect that mistakes will be made and purposely build safeguards to stop the dominos from falling.
The importance of contingency planning is not just necessary for the management of hazardous drugs. It is also true that many pharmacy directors inherit poorly designed workspaces that become more crowded over time fostering lapses in workflow. Think of the times when you were confronted with challenging regulations such as USP Chapter <797>, REMS, and medication reconciliation requirements from TJC. Perhaps certain formulary products suddenly cease to be available in bar coded unit dose packaging. Do these scenarios sound familiar?
These all too common obstacles impact safety planning in the pharmacy and require that the pharmacy manager or director be flexible, fleet, foresighted, and open-minded. Our aim at PP&P is to ease some of the burden of maintaining these virtues by sharing best practices from other pharmacy directors who have faced these same challenges and are willing to share their expertise (and their failures) with you. Learning from our own mistakes can be valuable, but learning from other’s mistakes is priceless.
All the best,
R. Mitchell Halvorsen
P.S. We would like to congratulate the winner of our 2010 ASHP Midyear booth giveaway—Mike Rinaldi, PharmD! Mike is an infectious diseases pharmacist at Waterbury Hospital in Waterbury, Connecticut. As the randomly selected winner, Mike received a 16GB Apple iPad. Keep your eye out for the next PP&P survey or come visit us at the ASHP Summer show in Denver for a chance to win our next prize giveaway.