This is the second part in a two-part series on pharmacy optimization and pharmacy staffing models. This part focuses on independent hospitals. Read our other blog post for more information on pharmacy staffing and optimization for multi-facility health systems and ACOs.
Most hospital pharmacies are staffed to manage peak loads of demand, which leads to both overstaffing during slow periods, and continued periods of understaffing, particularly during surges, sick-outs, vacations, and temporary leaves. Some hospitals still wrestle with the costs of 24/7 coverage during nights and weekends.
For understaffed periods, locum tenens and per diem pharmacists can offer a stopgap solution, but these pharmacists are generally much less efficient than your full-time staff. Temporary pharmacists must be trained on your EHR as well as your facility’s policies and procedures and it takes time to become proficient. And with high hourly rates, these resources aren’t always cost-effective.
Overstaffing is even more costly, as a full-time pharmacist earns an average of $108,000 per year in base pay. If these resources are dedicated to medication order review and verification and they are not fully utilized, it can come at a significant opportunity cost.
So how does an independent, community, or rural hospital maintain a 24/7 pharmacy without breaking the bank?
One answer is telepharmacy.
New Technology has Advanced Telepharmacy Performance
Telepharmacy can help. But not the old-school telepharmacy you’re probably thinking of.
Like the name implies, telepharmacy was initially conceived as a way for a lone remote pharmacist to enter medication orders by phone or fax. The lack of context and true connectedness generally meant that telepharmacy was utilized solely for highly routine remote order entry.
However, recent advances in telepharmacy technology have completely reshaped these dynamics. Using cloud-based software that is interoperable with any EHR, and workflow that is optimized for pharmacists, telepharmacists that work in a team-based model assigned and trained for specific hospitals can now operate as a true extension of your in-house team.
Advanced technologies now support scheduled coverage during a slow shift or planned leave of absence, for example, as well as the flexibility for on-demand coverage for an unexpected call-out, surge in activity, or emergency such as a weather event that prevents pharmacists from reaching the hospital.
Enabling New Staffing Models
Staffing up to meet peak demand is costing you real dollars and may still leave you with coverage gaps.
A well-known application of telepharmacy is to help independent hospitals or critical access facilities provide pharmacy coverage during nights and weekends.
For hospitals that already have 24/7 coverage, the new model that’s emerging calls for reducing staffing levels to where in-house pharmacists dedicated to medication order review are fully utilized, then applying flexible, cost-effective telepharmacy resources to supplement the team as needed. The result is an opportunity to redeploy in-house pharmacists to other clinical tasks, or to avoid or delay additional hiring.
Another model that is quickly gaining traction is the use of telepharmacists for 100% of medication order review and verification, a version of outsourcing that works when secured at a cost-effective price tag matched with high quality. This allows hospitals to dedicate their pharmacy resources more fully to collaborate on care teams and participate or lead clinical initiatives such as discharge management or antimicrobial stewardship.
Providing Transparency Into Operational Metrics and Costs
A quality system provides data and insights for better decision-making.
An important benefit of selecting a telepharmacy provider that utilizes cloud-based software is the ability to view real-time workflow metrics, including throughput at both department and facility levels. This helps management anticipate and address demand levels, review clinical interventions, and analyze prescribing patterns. Plus, highly detailed rollup and monthly reports should be provided to allow for billing to be easily reconciled against activity — so you always know exactly what you’re paying for.
The bottom line is that telepharmacy can now give smaller, independent hospitals the footing they need to achieve outstanding 24/7 pharmacy operations at a fraction of the cost of traditional methods.