Posted on October 30, 2018
Drug shortages are a continuing problem in the United States. Shortages can impact all aspects of the healthcare delivery system from patient safety and quality to financial operations and cost management. The American Society of Health-System Pharmacists (ASHP) defines a drug shortage as “a supply issue that affects how the pharmacy prepares or dispenses a drug product or influences patient care when prescribers must use an alternative agent.”
The drug shortage epidemic peaked in 2011, causing the U.S. Food and Drug Administration (FDA) to require that all drug manufacturers report anticipated and current shortfalls. In 2012, the FDA created the Safety and Innovation Act, requiring manufacturers to provide advance notification of expected disruption. However, drug shortages can be the result of myriad causes – natural disasters, production problems or shipping delays can affect availability nationwide, and unexpectedly high use or incorrect order volume may exhaust a hospital’s supply of an important drug unexpectedly. Sometimes there’s little advance notice of a shortage and the team needs to act fast to follow hospital policy and prevent patient harm.
Drugs continue to be the number one tool for managing and treating disease in the U.S. and that trend shows no signs of changing. Although there are fewer shortages now, more are occurring among drugs that are used commonly in the hospital setting. Hospitals nationally have recently reported drug shortages among critical care pain medications like fentanyl and morphine, as well as antibiotics, and products that are ubiquitous in every area of acute care facilities like IV fluids including 0.9% sodium chloride injections, and sodium bicarbonate1.
Leveraging your pharmacy teams’ expertise
Given the pharmacy team’s intimate knowledge of their hospital or system, having them conduct clinical surveillance throughout a hospital means they use their unique expertise to assess each patient’s medications and determine whether they are appropriate. Their goal is to ensure each patient receives the most effective drug for their medical condition, safe in the context of comorbidities and other medications and the most cost effect option.
Top performing hospitals are proactively adopting strategies to address drug shortages and maintain the highest quality of care. Best practices include:
Leveraging technology for real-time monitoring and alerts
Pharmacists have the knowledge and expertise—but they also need the tools to support key drug management initiatives. Electronic Health Records (EHR) are frequently tapped for insights in a patient’s individual care, but fall short when looking across a patient population to identify trends such as prescribing patterns of drugs at-risk for shortage. Clinical surveillance solutions can seamlessly integrate with EHRs to provide deeper insights and more robust tools for pharmacists managing a medication management initiative for their hospital.
Here’s one example of how it might work:
Drug shortages are here to stay. Leveraging the expertise of the pharmacy team and clinical surveillance technology to systematically monitor all of the patients in the hospital in real time, empowers clinicians to address shortages as soon as the situation occurs. What’s more, once a medication management plan is standardized and fully implemented system-wide, clinicians can consistently provide the safest and most appropriate medication for each and every patient and manage future shortages without compromising care.
1. FDA Drug Shortages website. https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm. Accessed July 19, 2018.2. Drug Shortages roundtable: Minimizing the impact on patient care. Am J Health Syst Pharm. 2018 Jun 1;75(11):816-203. Traynor K. Drug shortages a daily concern for emergency departments. Am J Health Syst Pharm. 2018 July 15;75(14):1007-84. Fink S. Drug shortages forcing hard decisions on rationing treatments. The New York Times. https://www.nytimes.com/2016/01/29/us/drug-shortages-forcing-hard-decisions-on-rationing-treatments.html. Accessed on July 23, 2018.