Weighing Pharmacy Staffing Models During COVID-19

It is without a doubt that COVID-19 has created a stressful work environment for many healthcare professionals and their facilities. The pharmacy department is not exempt. Being one of the largest cost centers in a hospital, it is often one of the most scrutinized. When patient volumes decrease and resources diminish, looking into the budget and making strategic maneuvers becomes a burden for directors and executives. Unfortunately, most administrators will tell you that spending on materials can often be marginally reduced, but the difficult truth is that the most impactful change to the expense line is labor costs. The question becomes, how does a facility maintain patient safety, but still decrease costs?

During the pandemic, cutting healthcare professionals seems illogical, but the economics of a healthcare facility are not immune to supply and demand. Clinics and hospitals have been seeing less clients for multiple reasons including, patients avoiding healthcare centers due to health risks and patients feeling that financial or time constraints don’t allow for utilizing healthcare.

Various solutions have been offered to combat the recent lack of patient volume. In the pharmacy department, patient safety is the highest priority and pulling onsite drug experts away from directly collaborating with the healthcare team and interacting with patients would be deleterious to that safety focus. By furloughing pharmacists, the health outcomes, costs, readmission rates, and so much more are at risk to be negatively impacted.

In the pharmacy department…

PTO coverage results in increased costs, even when in-house staff is utilized. If coverage from a temp-agency is required, there would be an increased cost for training and coverage. Facilities cannot absorb these numbers without decreasing the productivity of other employees and pulling away from their other essential tasks.

Regarding scalability and staffing efficiencies, very few options allow facilities to pay less for an employee if they are not at optimized levels of production. For example, if you have a pharmacist that has to verify 20 medication orders during one hour and 10 the next, a facility does not have the option of paying the employee a different amount for each hour.

Telepharmacy services, partnering with a remote team of clinical pharmacists and receiving 24/7 on call support, helps with labor cost issues and many other issues presented by COVID-19 by allowing for lower numbers of onsite staff members. Top benefits include increasing the ability to social distance, reducing the use of valuable personal protective equipment, and decreasing the risk of viral spread to objects and personnel, which can lead to a higher usage of PTO. Telepharmacy provides a tremendous outlet for staffing consistency, which impacts both productivity and safety. Instead of onboarding a temporary staff member that would join your team one week, and be gone the next, you can add an entire team of remote clinical pharmacists that will be trained to observe all of your policies and will have access to any updates or changes immediately, growing with you over the years.

Directly addressing PTO and other employee-related expenses, you will not have to pay telepharmacy PTO, you can avoid the costly HR onboarding process, you will skip the employee taxes and added cost for benefits, and you do not have to pay the high costs of temporary staffing. The efficiency that is added to your entire team by having telepharmacy handle remote order entry and verification is undervalued. Your onsite team can focus on direct clinical support, patient interactions, medication procurement and supply, etc. and allow your telepharmacy team to focus on the safety and wellness of your patients while processing medication orders.

Multi-tasking is another word for decreasing your overall productivity and taking on increased safety risks in healthcare.

Lastly, yet most importantly, the scalability offered through telepharmacy allows a facility to have 24/7 coverage of medication orders and pay for the work done and not the seat warmed.

With the significant amount of uncertainty in healthcare, hospitals and clinics are having to make difficult decisions. The ways that telepharmacy can allow a pharmacy department to maintain patient safety standards and decrease cost make it not only an attractive use of technology and flexible staffing, but an essential part of the future of healthcare.

Telepharmacy won’t replace the essential roles of the highly skilled onsite pharmacy team members, but it can play a major role to enhance the overall level of impact on patient outcomes.  While telemedicine and telehealth are innovative and exciting new approaches to healthcare, it’s time for telepharmacy to be leveraged to provide the same level of convenience and cost savings during this pandemic.   

To explore innovating your telepharmacy strategy, learn more here.

Having Trouble Sleeping?

Sleeping vs Aging

Are sleeping problems just apart of the aging process? The answer is “NO!” There are physiologic changes that help to contribute to insomnia, however, many environmental factors as well as chronic medical conditions also contribute to insomnia in this population.

Physiologically, the sleep patterns change as we age:
1. Sleep initiation is more difficult
2. Total sleep time and sleep efficiency is decreased
3. Sleep fragmentation increases
4. More time is spent in bed awake
5. Circadian rhythm changes, making you go to bed earlier and waking up earlier.

There are 3 categories of insomnia:
Transient – Lasts no more than a few nights at a time
Acute – Lasts less than 3-4 weeks
Chronic – Lasts more than 3-4 weeks.

Transient or Acute usually has an identifiable cause of insomnia such as acute medical illnesses, jet lag, change in sleeping environment and acute/recurring psychological stressors.

Studies have shown that medications are not always the best choice or even effective for sleep problems as they can lead to dependence and rebound insomnia if stopped. Behavior therapy is safe and has been found to produce durable and reliable changes in sleep that can have lasting effects. They include:

1. Relaxation Therapy – The goal is to lower pre-sleep cognitive arousal by progressive relaxation. This is very useful for individuals with tension and anxiety.
2. Stimulus-Control Therapy – Limiting the use of the bedroom to sleep; TV and bright lights should be avoided; bedtime needs to be perceived as a time for sleep. This is useful for patients who have irregular sleep-wake schedules.
3. Sleep-Restriction Therapy – This is used when excessive time is spent in bed. This usually requires 4-6 weeks to induce a mild sleep loss that increases the ability to fall and stay asleep.
4. Cognitive Therapy – Provides reassurance to patients that sleeping less than 8 hours a night is not necessarily unhealthy and does not always lead to dramatic consequences the next day.

Can I Take That If I’m Pregnant?

Antidepressants During Pregnancy

You have just found out your pregnant, but what about the medications you are on? How will they affect an unborn baby? One of the most frequent question regarding fetal harm and medication use is with antidepressants. Many doctors advise to stop these medications during pregnancy, but that may not be necessary.

Studies have shown that there is generally no need to taper off antidepressants when pregnant. Also, untreated depression may cause more harm to the unborn child. Untreated depression in the mother can lead to preterm birth and low birth weight. Babies of depressed mothers also have higher levels of cortisol. This increases the risk of the baby developing depression, anxiety and behavioral disorders later in life.

Have said this, while it is not widely thought that antidepressants cause birth defects, they still may affect the baby. About 30% of babies who had a mother that took an SSRI (Prozac, Zoloft, Celexa, Paxil) while pregnant experience neonatal adaptation syndrome. This can cause jitteriness, irritability and respiratory distress. However, it is unknown if this is from the effect of the drug or the withdrawal of the baby from the SSRI after birth. Doctors might run a few tests, but this syndrome will go away. These symptoms can also happen when a mother doesn’t take an SSRI.

Remember, medication risks typically are not greater than those of an untreated mental illness. It is very important to talk with you Primary Care Provider or OB-GYN and weigh the risks of the medication vs. the risks of untreated disease and make the best decision for your specific situation.

Are You Maximizing Your Genetic Potential?

AM I TRAINING TO MY POTENTIAL?

Are you taking a class at the gym?  Do you workout on a daily basis and see some results, but not exactly what you wanted?  There are broad practices that can be used to help increase athletic performance.  However, research is showing that the “one size fits all” model may not be the best way to reach your goals.

Usually with training or working out, you see what works and what doesn’t by a trial and error method. You see how you respond to a certain exercise or dietary change, and then decide if you should continue or try something else. This can be very frustrating as it takes a lot of time to go through these steps. You can make informed decisions, but the results of your hard work may not be evident. This is where genetic testing can be very valuable. Genetic testing can give you information that helps progress come more rapidly by identifying what works best for YOU, based on your specific genetic makeup. You can individualize exercise routines and dietary needs to give you a competitive edge, give your body the fuel it requires and possibly reduce the risk of injury.

Knowing your predispositions can give you information and guidance on :
• The type and duration of exercise intensity
• Frequency of your workouts to maximize results
• Proper rest periods to decrease injury risk

These predispositions are not the goal of your training, however.  Trial and error will still be present, but they give you answers on how to maximize your potential with fewer trials.

Training time is limited and genetic testing gives you the ability to use this time more effectively and reach your goals much more smoothly.