Pharmacy Leaders Research Articles

Creation of a pharmacy leadership certificate program for pharmacists and pharmacy technicians using an innovative, low-cost framework.

To describe the creation of a statewide leadership training program for practicing pharmacists and pharmacy technicians. The 2 overarching goals were to (1) enable learners to develop foundational leadership skills that could be used at their place of work or would enable them to take on a new or advanced role and (2) help foster sustainability within our state pharmacy society through incorporation of the learners on committees and projects, bringing awareness to board member roles and functions. Overall, the program's mission was to empower practicing pharmacists and pharmacy technicians to take on leadership roles within their organization and the state pharmacy society. Leadership training for pharmacists and pharmacy technicians can be variable, elusive, and costly. We provide our experiences in establishing a 1-year leadership certificate program affiliated with the state pharmacy society. In the first 4 years, a total of 15 program fellows have graduated, with 8 more set to finish in September 2022. Since completion of the program, a majority of the graduates have taken on new leadership positions (65% have accepted new leadership positions and 35% have been elected to state pharmacy society board positions). Implementation of a statewide pharmacy leadership program provided a low-cost, high-value option to develop local leaders, in affiliation with a state pharmacy society.

Gender inequality in PGY1 residency leadership positions and conferral of health-system pharmacy professional awards.

To address gender inequality, the American Society of Health-System Pharmacists (ASHP) created a steering committee that recommended the collection of baseline and ongoing metrics of pharmacy leadership. The purpose of this study was to quantify gender inequality in distributions of residency program director (RPD) and director of pharmacy (DOP) positions and to investigate gender distributions among recipients of ASHP professional leadership awards. RPD and DOP information for postgraduate year 1 (PGY1) programs included in the online ASHP residency directory were collected in December of 2020. Publicly available records were used to collect information on recipients of the Harvey A.K. Whitney Award and John W. Webb Award during the periods 1950-2020 and 1985-2020, respectively. Gender information for RPDs, DOPs, and award recipients was collected from listed pronouns available in public records. A χ 2 test was used for analysis of the collected data. A total of 1,176 PGY1 residency programs were included. Of the RPD positions assessed, 66% (n = 775) were filled by women pharmacists (P < 0.0001), while the percentage of DOP leadership positions held by women was 42% (n = 496) (P < 0.0001). Evaluation of data on recipients of the Harvey A.K. Whitney Award and John W. Webb Award revealed the occurrence of female recipients is 19.7% (n = 14) and 16.7% (n = 6), respectively (P < 0.0001). RPD positions have a higher prevalence of being filled by women. DOP positions remain male-dominated and revealed gender inequality among senior-level leadership roles. Pharmacy leadership award analysis identified further gender inequality. The results from the study serve as a baseline of current gender metrics for pharmacy leaderships in hospital systems with PGY1 residency programs.

Brighter horizons: The necessity of concentrated sponsorship targeted toward minoritized student pharmacists

Due to the effects of structural racism, disproportionately lower numbers of Black, Hispanic or LatinX, American Indian, and Alaska Native students pursue a career in pharmacy and successfully matriculate into the profession. Despite these disparities being present for many years, little progress has been achieved in diversifying the pharmacy profession, resulting in a persistent lack of diversity within pharmacy leadership across employers and pharmacy organizations. Consistent with recent recommendations for improving diversity in pharmacy, the PharmGradWishlist (PGWL) initiative was created as a way for practicing pharmacists and organizations to provide direct financial sponsorship to racially and ethnically minoritized trainees to offset costs incurred during training and during the transition from student to practicing pharmacist. Many of these costs, such as residency and fellowship application fees, job interview travel costs, board exam and licensing fees, and moving expenses, are not typically subsidized by federal student funding. Offsetting these costs is an important way to reduce barriers to entering the profession and postgraduate training, the latter of which may be particularly important in trainees’ pursuit of academic and leadership positions in pharmacy. The initial development and advertisement of the initiative occurred through social media and the grassroots efforts of the PGWL team, a group of 10 volunteer pharmacists from across the country, and resulted in generous donations from a small proportion of practicing pharmacists nationwide. It is now time for the profession as a whole to embrace the role of direct sponsorship in improving diversity in the profession. We call upon pharmacists and pharmacy organizations to advocate for and participate in financial sponsorship of racially and ethnically minoritized trainees and pharmacists as a way to increase diversity and promote health equity.

Fundamental issues and pandemic pushes pharmacists past their limits

Fundamental issues and pandemic pushes pharmacists past their limits

Considerations When Transitioning From Health-System Pharmacy Administration and Leadership Resident to Pharmacy Leader.

A key part to assimilating into an organization in a leadership role is managing transitions. Health-System Pharmacy Administration and Leadership (HSPAL) Residency Programs focus on laying the foundation for continued growth in management and leadership skills. This article focuses on keys for transitioning from HSPAL Pharmacy Resident to Pharmacy Leader. Managing transitions is and will continue to be an important topic for all leaders. As HSPAL Residents transition to new pharmacy leaders, understanding pharmacy practice building relationships, maintaining them, and having a thoughtful strategy through this transition will allow for a more complete understanding of the organization to navigate complexities, develop people, and complete projects and initiatives. While this article is specific to HSPAL residents, these concepts can apply to the transition to pharmacy leaders.

Looking two steps ahead

It is a tremendous honor for me to be selected to provide the John Webb Lecture this year. There is nothing better than being recognized by your peers, for which I am truly appreciative. I want to especially thank all of my friends, colleagues, and former residents who supported my nomination. In addition, my sincere appreciation to the ASHP Section of Pharmacy Practice Leaders and the John W. Webb Lecture Award selection committee for choosing me when I know there are so many other great pharmacy leaders who also deserve to be recognized for their contributions to the profession. Knowing this makes the award that much more special to me. Thanks also to Dr. Tatiana Bronich, dean of Northeastern’s School of Pharmacy and Pharmaceutical Sciences, for hosting today’s event. Thanks to my friends in Boston, Bill Churchill, Chris Fortier, John Fanikos, and Ross Thompson, for being such great colleagues. I have greatly enjoyed the times we have had together.

Pharmacy leader reflects on pharmacy reaching its full potential

Pharmacy leader reflects on pharmacy reaching its full potential

RPS proposes 'single leadership body' to credential pharmacists and pharmacy technicians

The Royal Pharmaceutical Society (RPS) should represent pharmacy technicians as well as pharmacists, for “a more unified approach to pharmacy leadership”, it has said. In the RPS’s response to a call for evidence as part of the ‘Independent Commission into Pharmacy Professional Leadership’, it said that forming a single leadership body for both professions “will […]

The Journey to Advanced Clinical Pharmacy Practice: Global Collaboration Will Accelerate the Pace

The Journey to Advanced Clinical Pharmacy Practice: Global Collaboration Will Accelerate the Pace

A state affiliate's utilization of ASHP's Practice Advancement Initiative 2030 to identify current state of practice and a process to prioritize goal achievement.

The American Society of Health-System Pharmacists (ASHP) has been a long-standing supporter of advancing pharmacy practice, specifically in the area of pharmacy practice models. In 2019, ASHP began the planning to launch PAI (Practice Advancement Initiative) 2030. PAI 2030 describes and details a bold vision for patient care, medication use, and pharmacy practice over the next decade. This work represents an ambitious goal to continue to advance the profession of pharmacy for the betterment of our patients. While much has been accomplished with the PAI, there is little literature on PAI 2030 (the authors are unaware of any published examples). The purpose of the article is to explain a novel state affiliate's prioritization of ASHP's PAI 2030 recommendations. In the spring of 2020, the North Carolina Association of Pharmacists (NCAP), the North Carolina state affiliate of ASHP, began discussions around PAI 2030. In the fall of 2020, prior to the NCAP Annual Convention, health system pharmacy leaders within NCAP developed a questionnaire to serve as a PAI 2030 self-assessment. This approach allowed a state affiliate to implement an innovative program to act on the recommendations from PAI 2030. After the prioritization, health system pharmacy leaders engaged in discussion to comment on what recommendations have been identified. The goal of this discussion was to provide NCAP a direction to pursue focused efforts to support recommendations of PAI 2030. Ultimately, NCAP seeks that this statewide approach would help advance pharmacy practice, and improve pharmacy practice across the state of North Carolina in collaboration with NCAP. This discussion illustrates how a state affiliate has pursued implementing PAI 2030. This approach provides a strategy for state affiliates in addressing the recommendations within PAI 2030. A novel statewide approach can help marshal resources to advance practice when health systems partner with a state affiliate.

Addressing COVID-19 Barriers to Clinical Trial Enrollment and Implementation in the PHARM-DC Study

Recent hospitalization puts older adults at higher risk of experiencing adverse drug events (ADEs) that are a common cause of hospital readmission. Yet, most ADEs are preventable. The PHARMacist Discharge Care (PHARM-DC) study is a multi-site randomized controlled trial that seeks to evaluate the effect of pharmacist-led peri- and post-discharge interventions on 30-day hospital readmissions among older adults taking ≥10 medications or ≥3 high-risk medications. The PHARM-DC intervention includes pharmacist-led patient counseling, medication reconciliation at discharge, and a follow-up phone call post-discharge. We will highlight study protocol adaptations undertaken during the COVID-19 pandemic to address challenges to enrollment and to minimize risk of COVID-19 exposure for study participants and research personnel. Additionally, we will share insights from focus groups and semi-structured interviews with pharmacist interventionists and pharmacy leaders on barriers and facilitators to implementation due to the pandemic and strategies for future clinical trials to overcome barriers.

106. Pandemic Pinch: The Impact of COVID Response on Antimicrobial Stewardship Program (ASP) Resource Allocation

BackgroundThe COVID-19 pandemic placed a strain on inpatient clinical and hospital programs due to increased patient volume and rapidly evolving data on best COVID-19 management strategies. However, the impact of the pandemic on ASPs has not been well described. MethodsWe performed a cross-sectional electronic survey of stewardship pharmacy and physician leaders in 37 hospitals within the Duke Antimicrobial Stewardship Outreach Network (DASON) (community) and Duke/UNC Health systems (academic) in April-May 2021. The survey included 60 questions related to staffing changes, use of COVID-targeted therapies, related restrictions, and medication shortages.ResultsTwenty-seven facilities responded (response rate of 73%). Pharmacy personnel was reduced in 17 (63%) facilities by an average of 16%. Impacted pharmacy personnel included the stewardship lead in 15/17 (88.2%) hospitals. Converting to remote work was rare and only reported in academic institutions (n=2, 7.4%). ASP personnel were reassigned to non-stewardship duties in 12 (44%) hospitals with only half returning to routine ASP work as of May 2021. Respondents estimated that 62% of routine ASP activities were diverted during the time of the pandemic. Non-traditional, pandemic-related ASP activities included managing multiple drug shortages, of which ventilator support medications (91%) were most common affecting patient care at 52% of facilities. Steroid and hydroxychloroquine shortages were less frequent (44% and 22%, respectively). Despite staff reductions, pharmacists often served as primary contact for remdesivir approvals either using a criteria-based checklist at dispensing or as part of a dedicated phone approval team (Figure). Most (77%) hospitals used a criteria-based pharmacist review strategy after remdesivir FDA approval. Restriction processes for other COVID-19 therapies such as tocilizumab, hydroxychloroquine, and ivermectin were reported in 64% of hospitals.Remdesivir Allocation Strategy Proportion of facilities implementing specific remdesivir allocation strategies from the time of the first US Food and Drug Administration (FDA) Emergency Use Authorization (EUA) through FDA approvalConclusionPandemic response diverted routine ASP work and has not yet returned to baseline. Despite the reduction in pharmacy personnel due to the pandemic, the ASP pharmacy lead took on a novel and critical stewardship role throughout the pandemic exemplified by their involvement in novel treatment allocation for COVID patients.Disclosures Melissa D. Johnson, PharmD, MHS, Astellas (Consultant, Grant/Research Support)Charles River Laboratories (Grant/Research Support)Cidara (Consultant)Merck & Co (Consultant, Research Grant or Support)Paratek (Consultant)Pfizer (Consultant)Scynexis (Scientific Research Study Investigator)Theratechnologies (Consultant)UpToDate (Other Financial or Material Support, Author Royalties) Sonali D. Advani, MBBS, MPH, Nothing to disclose Rebekah W. Moehring, MD, MPH, UpToDate, Inc. (Other Financial or Material Support, Author Royalties)

123. Formal Pediatric Antimicrobial Stewardship Program at a Children’s Hospital Within a Larger Academic Medical Center Decreases Antimicrobial Prescribing

Abstract Background Antimicrobial stewardship is a coordinated approach to antimicrobial overprescribing, an avoidable contributor to adverse events in children. Implementation of a formal pediatric antimicrobial stewardship program (pASP) in a children’s hospital within a hospital poses unique challenges due to staffing, funding, and institutional priorities. We hypothesized that a formalized pASP would decrease antimicrobial prescribing in a children’s hospital within a large academic medical center. Methods We extracted pharmacy administration data for all patients receiving systemic antimicrobials in a tertiary care, academic children’s hospital in Upstate NY from 3/1/2020-5/31/2021. We grouped patients into floor (including patients with surgical, hematologic, and oncologic processes), pediatric intensive care unit (PICU), and neonatal intensive care unit (NICU). We calculated antimicrobial days of therapy per 1000 patient days (DOT/1000PD) for 6 months before, 3 months during, and 6 months after institution of pASP. The formalized pASP involved physician and pharmacy leadership of prospective audit and feedback. We developed run charts and used two-way analysis of variance (ANOVA) with an effect of location, an effect of the intervention, and an interaction effect. Significant effects were then tested using Tukey’s test for multiple comparisons. Results Run charts are displayed in figures 1-3. Overall, the pediatric floor(DOT/1000PD=1181) had significantly higher prescribing than the PICU(847), which was significantly higher than the NICU(327) (p&amp;lt; 0.001, ANOVA). Antimicrobial prescribing after pASP dropped by 80 DOT/1000PD (98%CI: 23 to 137) (p=0.008; Tukey’s test) after including the effect of location. The interaction effect was not significant (p=0.77; ANOVA) suggesting that the intervention did not have a significantly different effect in the three locations. Variation in Antimicrobial Prescribing on the Pediatric Floors Variation in Antimicrobial Prescribing in the Pediatric Intensive Care Unit Variation in Antimicrobial Prescribing in the Neonatal Intensive Care Unit Conclusion Antimicrobial prescribing decreased following implementation of a formalized pASP in a children’s hospital within a large academic medical center. Despite unique challenges with implementation in this environment, antimicrobial stewardship remains effective. Variation between floor, PICU, and NICU antimicrobial prescribing was also notable. Disclosures All Authors: No reported disclosures

Clinical pharmacy initiative to increase naloxone prescribing in patients with opioid use disorder

AbstractIntroductionThe national opioid epidemic has garnered the attention of various health agencies. A leading strategy in mitigating risk from the opioid public health crisis, including opioid use disorder (OUD), is via increased promotion and access to the lifesaving opioid antagonist, naloxone. Pharmacists have been recognized as integral in addressing this emergency; however, literature evaluating outcomes from multifaceted clinical pharmacy specialist (CPS) interventions and involvement is lacking. The purpose of this quality improvement initiative was to evaluate the impact of a CPS initiative to increase naloxone prescribing proportions (number of patients with OUD with an active prescription for naloxone within the past year divided by the number of patients with OUD), patient access to care, and clinical interventions.MethodsPain management CPSs, mental health CPSs, and clinical pharmacy leadership within a Veterans Health System spearheaded a variety of interventions to increase naloxone prescribing in patients with OUD including focused education with prescribers, naloxone informational letters, review of population management tools identifying patients with OUD indicated to receive naloxone, CPS naloxone prescribing, and automated naloxone drug orders integrated into electronic health record progress note templates. The preintervention and postintervention evaluation periods were three‐month time frames. Naloxone prescribing proportions were compared before and after implementation of these interventions. Additional outcomes evaluated were number of encounters, number of patients seen/reviewed, and number of clinical interventions completed by the CPSs.ResultsThere was a significant increase observed in naloxone prescribing proportions from 34.1% to 57.5% postintervention (P &lt; .01). The total number of encounters, patients, and clinical interventions had an absolute increase of 58.0%, 88.4%, and 49.9%, respectively, postintervention.ConclusionThe observed improvement in naloxone prescribing proportions suggests the value of CPS involvement in initiatives for increasing naloxone prescribing to optimize patient safety and justify clinical pharmacy services.

Lessons from pandemic bolster response to weather emergency.

Ochsner Health’s experience with remote work during the COVID-19 pandemic helped the health system weather Hurricane Ida, which made landfall Sunday, August 29, 2021, approximately 100 miles from New Orleans in Port Fourchon, LA. Deborah Simonson, system vice president of pharmacy services for the health system, and Ryan Pepper, assistant vice president for the pharmacy supply chain, remained onsite at Ochsner Medical Center in New Orleans throughout the storm. But other system pharmacy leaders who normally ride out weather emergencies were positioned far from Ida’s path to provide continuous remote support. “Before COVID-19, we had a lot more people come onsite,” Simonson said. “With Hurricane Ida, we had to follow COVID-19 safety protocols, so we could not have our entire Team A on site. We really depended on support that we’d moved outside the impact zone.” She said the leadership team functioned as a command center to handle urgent requests from hospitals for supplies, staffing, and other assistance. Despite some storm-related communication issues, the overall process worked well, and Simonson said she wants to refine this model and use it during future emergencies.

A safe in-home disposal system with every opioid prescription? Food and Drug Administration is considering a potential new Risk Evaluation and Mitigation Strategy that could impact pharmacists

Misuse of prescription opioids contributes to the ongoing crisis of opioid-related overdose and deaths in the United States. The failure of patients and caregivers to safely dispose of unused opioids contributes to the problems. In 2018, Public Law 115-271 provided U.S. Food and Drug Administration (FDA) authority to mandate a Risk Evaluation and Mitigation Strategy (REMS) for safe disposal packaging or safe disposal solutions for opioid analgesic medications. FDA has been collaborating with stakeholders to determine whether a new REMS is needed. A new or revised opioid REMS could substantially affect opioid packaging, pharmacist roles and services, and dispensing activities such as education, counseling, and product distribution. The pharmacy profession has provided limited input to FDA regarding a potential new or revised opioid REMS. In this commentary, we aim to (1) provide awareness and raise questions on pertinent issues regarding opioid use and safe home disposal, (2) offer considerations for regulators on needed research in the development and assessment of a new REMS, and (3) highlight actions for pharmacist engagement in patient care services to promote safe use and safe home disposal of opioids. Consideration of a potential mandate regarding enhanced safety packaging or safe disposal solutions for opioids presents opportunities to revisit professional roles and engage proactively with FDA and other stakeholders. We hope this commentary stimulates timely feedback by pharmacy leaders, researchers, and practitioners on whether and how options for safe home disposal of opioids should be included in a REMS in contemplation of potential benefits, unintended consequences, expanded professional roles, timeline, assessment of program effectiveness, and adequate compensation. We support a shared opioid REMS that funds the counseling of patients and caregivers on safe opioid use and safe home opioid disposal options and provides appropriate education and products to facilitate that disposal.

A required course in leadership, entrepreneurship, and administration in pharmacy

Context: Worldwide, there is growing interest in equipping pharmacy graduates with the requisite skills to assume responsibilities related to management and leadership in the profession. To meet this need, the required course “Leadership, Entrepreneurship, and Administration in Pharmacy” is provided as a culminating experience for pharmacy students. Description of course: In this course, students learn concepts related to management, leadership, and entrepreneurship and complete assignments including financial statement exercises, human resources management simulations, personal leadership development plans, and business plan projects with professional poster presentations. The course in its current form has been offered four times to 541 students. Evaluation: Student evaluations (n=214) show the course is well-received and provides opportunities to develop knowledge and skills not covered previously. As the pharmacy profession is constantly evolving, students need a strong foundation in management, leadership, and entrepreneurship. Sharing experiences from this course will aid faculty at other institutions wanting to include similar topics in their curriculum.

Moving toward health equity: A journey

Moving toward health equity: A journey

Roadblocks and successes in preparing COVID-19 vaccination clinics: Perspectives from pharmacy residents.

PurposeTo outline logistics challenges, barriers, and successes in the development of separate programs for mass COVID-19 vaccine distribution and administration to healthcare employees and community members.SummaryIn the face of the global coronavirus disease 2019 (COVID-19) pandemic, COVID-19 vaccine development and distribution became a worldwide priority. AdventHealth Orlando was selected as the central hub for vaccination efforts for central Florida. There was a need to quickly evaluate literature, patient safety, and institutional resources and logistics to coordinate the development of employee and community vaccination clinics. These efforts were driven by postgraduate year 2 residents in health-system pharmacy administration and leadership, medication-use safety and policy, and informatics. Clinic development focused on 4 key areas: vaccine quality control, secure inventory movement, safe preparation and administration, and consolidation of inventory. Healthcare worker vaccinations were administered on the health system’s main campus, and community vaccination events were carried out at temporary clinic facilities set up in the parking lot of Orlando International Airport.ConclusionIn a mass COVID-19 vaccination initiative directed by the pharmacy enterprise leadership of a large Florida health system, postgraduate year 2 pharmacy residents played a key role in developing and implementing vaccination clinics targeting healthcare worker and community populations. During multiple vaccination events, a total of more than 50,000 COVID-19 vaccine doses were administered, with minimal to no vaccine wastage.

2021 ASHP Conference for Pharmacy Leaders

2021 ASHP Conference for Pharmacy Leaders Get access American Journal of Health-System Pharmacy, Volume 78, Issue 17, 1 September 2021, Pages 1603–1626, https://doi.org/10.1093/ajhp/zxab299 Published: 30 August 2021 Article history Corrected and typeset: 30 August 2021 Published: 30 August 2021