Addressing Ongoing Hospital Pharmacy Staffing Challenges

More and more demands are being placed on hospital pharmacists, from expanded medication adherence responsibilities to clinical cost savings initiatives, as well as retail strategies and overseeing stewardship programs. With 53.6% of hospitals reporting some level of pharmacy service integration coupled with a deficit in pharmacy staffing, advanced roles for pharmacists and technicians are emerging.

Such a broad spectrum of duties and responsibilities can lead to pharmacist burnout and decreased performance of hospital pharmacies. Based on our experience, inpatient pharmacies account for as much as 20% of a hospital’s operating budget, making it essential that they perform as efficiently and effectively as possible.

Such a broad spectrum of duties and responsibilities can lead to pharmacist burnout and decreased performance of hospital pharmacies. Image Credit: © Piman Khrutmuang - stock.adobe.com

For example, medication reconciliation, bedside discharge medication, and patient counseling services are increasingly falling under the purview of hospital pharmacists in an effort to reduce the rate of 30-day readmissions.

At the same time, pharmacists often lead hospital-wide clinical initiatives that are aimed at improving patient outcomes and controlling costs, placing even more demands on their time as they deal with research, analytics, and reporting.

Furthermore, hospitals and health systems in search of new revenue streams are turning to pharmacy leaders to develop and implement retail strategies—yet adding this entirely new business model to their growing list of responsibilities brings with it challenges that result from the different inventory practices, financial operations, payor contracts, reimbursements, and other functions that traditionally the inpatient pharmacy staff may not be equipped to handle.

Compounding these hurdles, hospital pharmacists are also charged with overseeing opioid and antimicrobial stewardship and other clinical programs, many of which have changing regulatory requirements to research and implement.

Solutions to Staffing Challenges

However, there are solutions that can help pharmacy teams overcome these challenges. At Cardinal Health, we collaborate with hospitals and health systems of all sizes and types. Through this work, we have learned that infusing the inpatient pharmacy team with the resources and support needed to absorb its expanding roles through pharmacy management is one approach many hospitals have adopted. This outsourcing process can provide additional experts, tools and support—such as an experienced team of pharmacists, Lean Six Sigma managers, and regulatory experts—who can help pharmacy manage the multiple operational facets unique to its organization’s needs and patient populations.

This approach has been shown to improve performance. Based on our 2021 pharmacy adjusted patient days, pharmacies that have implemented this outsourcing method have achieved, on average, a 17% reduction in drug costs compared with national averages for other hospitals.2

Further, not only do the additional resources that come with outsourcing improve pharmacies financially, the additional resources also free up pharmacy staff to focus on clinical programs, patient rounds, data analytics on program savings, medication reconciliation, discharge counseling and other high-level tasks, rather than being constrained by the many demands of day-to-day pharmacy operations.

Another potential solution is remote pharmacy staffing models, which have been successfully leveraged for small- and mid-size hospitals as well as larger organizations. With remote pharmacy staffing models, off-site pharmacists and technicians serve as extensions of the on-site pharmacy team. These teams can supplement the on-site pharmacy staff because they are trained on each hospital’s policies and procedures, as well as have an understanding of compliance measures.

For small- and mid-size hospitals, remote pharmacy models can help achieve 24/7 coverage, and provide coverage during peak times or during unplanned leaves and emergencies. Especially with today’s staffing shortages, this model can be helpful toward maintaining and expanding a pharmacy’s service levels and offsetting staffing constraints.

Large hospitals also derive similar benefits from remote pharmacy models. For example, this model is often leveraged to free up on-site staff to focus on large technology implementation projects like pharmacy information system and electronic medical record conversions, computerized provider order entry implementations, and bedside barcoding.

Most importantly, for hospitals of all sizes, pharmacy outsourcing and remote pharmacy models can help retain high-value, experienced pharmacists. At a time when pharmacist burnout and turnover is higher than ever before, talent retention is increasingly a strategic imperative for today’s hospitals.

About the Author

Michael D. Brown is the vice president of managed services at Cardinal Health.

REFERENCE

Pedersen CA, Schneider PJ, Ganio MC, Scheckelhoff DJ. ASHP National Survey of Pharmacy Practice in Hospital Settings: Workforce - 2022. Am J Health Syst Pharm. 2023;80(12):719-741. doi:10.1093/ajhp/zxad055