ASCP CEO: Pharmacy Has the Opportunity to Step Up, Fill Gaps in Care in Nursing Homes With Staffing Challenges

Pharmacy has done an incredible job stepping up to the emergency of COVID-19 and exerting its force as a profession, explained Chad Worz, PharmD, BCGP, FASCP, executive director and chief executive officer of the American Society of Consultant Pharmacists (ASCP) during a session at the ASCP conference. Worz noted that during the pandemic, many pharmacists stepped up to do work that they had never expected would be part of their roles.

“I never thought I would immunize—it's been an incredible shift for pharmacy,” Worz said.

Worz noted that with infectious outbreaks becoming a greater concern, health care systems are now looking to assess the future of addressing infection prevention and control on a broader scale. Worz explained that pharmacists’ role in that future could be critically important.

“The new CMS regulations particularly call out a pharmacist as someone that can be a preventionist for infections in nursing homes,” Worz said. “That's significant to be recognized as an individual that can assume those responsibilities.”

Worz noted that there have been staffing struggles in nursing homes. However, these staffing challenges could be an opportunity for pharmacists to expand the ways they provide support in long-term care (LTC) facilities.

“Immunization is an example of that—nursing homes didn't want to do immunization. They said, ‘Pharmacy, please do this for us.’ And we did. That's a responsibility that ultimately comes back to us in reimbursement methods and value-based care opportunities downstream,” Worz said.

Worz noted that the numbers remain staggering—during the pandemic, pharmacists delivered 8 million vaccinations in LTC facilities.

“It's amazing. And I think it's just the tip of the iceberg,” Worz said. “We've developed an infrastructure. Pharmacies are Medicare Part B billers for mass vaccinations. We've connected ourselves to the state information systems for vaccines. We've developed procedures and figured out how to make sure the vaccine arrived at the facility the same day, and the consultant pharmacist is there to administer vaccines in a lot of cases.”

Worz noted that this responsibility is a powerful one that is changing the profession for the better.

“It's the door that opens up the provider opportunities for pharmacy and other things like diabetes and chronic care management. We have a current piece of legislation that aims to codify that,” Worz said. “The [Equitable Community Access to Pharmacist Services Act (ECAPS)] legislation may feel like a community-based piece of legislation, but it has implications across pharmacy.”

There are also new vaccines coming, with respiratory syncytial virus vaccines on the horizon, Worz explained. There have been changes in the pneumococcal vaccines in the last 3 or 4 years, and there also has been a change in the influenza recommendation for people over 65 years of age. However, Worz noted that with these numerable vaccines available, there also has been vaccine fatigue as well.

“But we have a responsibility to make sure our patients are offered the right vaccines at the right time to keep them healthy. And again, I think that's a tremendous opportunity for pharmacy,” Worz said.

In February 2020, there were 1.6 million LTC workers in facilities just before the pandemic, Worz explained. In July 2022, there's 1.4 million.

“That’s a huge decrease. Maybe it doesn’t look like a whole lot because it’s only 200,000 people, but we also only have 15,000 nursing homes. There's a lot of individuals that are displaced from the workforce, and again, a lot of opportunity for pharmacists to step in and do more things at nursing homes to support them, as they kind of rebuild their labor structure,” Worz said.

Worz explained that pharmacists had to do a lot in communities during the COVID-19 pandemic as well due to gaps in care. As questions were asked about how to vaccinate people locked down in their homes, pharmacists answered this call with mobile vaccination clinics and at-home visits.

As further questions were raised about how to vaccinate the homeless or people living in rural areas that don't have adequate access to health care, or even how to approach cultures, ethnicities, and religions that have hesitations about vaccines—those are areas pharmacists stepped up to address by innovating and figuring it out during the pandemic, Worz noted.

“I remember arguing with federal agencies about the fact that a pharmacy was drawing up COVID-19 syringes and sending out their team to multiple people's houses to give that initial COVID-19 vaccine, and the agency is going, ‘I'm not sure you can do that. Will it be stable? Is it okay?’ Ultimately, we needed to do it—that was the only way to get access to those individuals for vaccines,” Worz said. “That's the innovation and the power the pharmacy brought to the pandemic.”

Worz explained that these efforts also ultimately brought a lot of chips to the table for pushing forward the value of the pharmacist at the federal level in federal agencies and in legislation.

“So we did our job—I think we all ran into that burning building and did our job during the pandemic,” Worz said. “We became immunizers, we provided services where they were needed, and we collaborated with other disciplines to get things done.”

Reference

Worz C. Opening General Session. Presented at: American Society of Consultant Pharmacists (ASCP) 2022 Annual Meeting in San Antonio, TX; November 4, 2022.