Planning for drug shortages in LTC
Regional, national and local drug shortages are constantly changing. One month there may be a severe shortage of one item, while the next month healthcare providers have access to a steady supply. This issue causes gaps in care, and in a facility with a high-risk population to begin with, shortages could put patients' health in jeopardy.
Some drugs have limited options for a therapeutic equivalent In those instances, facilities may need to delay a treatment or use a different drug that may change the drug interaction profile. Fifty-three percent of facilities that participated in a national survey noted that one to ten medication errors occurred in their facility as a result of a drug shortage.
In addition to being a threat to patient safety, drug shortages can become a very time- and labor-intensive situation for pharmacy managers and care givers to monitor for and manage. This is particularly true if patients have multiple co-morbidities and if the facility does not have the right processes in place to handle shortages. When there is a severe shortage, caregivers will need to identify all of the patients affected, evaluate impact of delay in therapy or therapeutic alternative, and write the appropriate change orders. Facilities must have a plan in place to turn to when they are faced with this drug shortage situation.
Enacting a Plan
Working alongside a pharmacy, long-term care facilities should be refining and reworking their plan for drug shortages on an ongoing basis to maintain high patient safety. Questions they should be able to answer include: Sourcing options? Stocking levels at the pharmacy until drug is unavailable? What are the clinical support resources to work with medical staff in order to develop an appropriate plan? What is the operational plan to execute response?
Long-term care pharmacies and facilities should also have a good understanding of their inventory on hand and be able to determine utilization rates for each medication. In addition, caregivers should recognize which drugs will cause the most disruption when they suddenly are in short supply. The drug environment will change, so it is imperative that clinicians react quickly when there is no way to access the necessary drug.
Relationships Between Long-Term Care Facilities and the Pharmacy
To ensure that the plan is secure, long-term care facilities must work closely with their pharmacies.. Long-term care providers must also ensure that their pharmacies have visibility across multiple locations so that medications can be mobilized across facilities when necessary. There should be good geographic balancing across multiple pharmacies when times of utilization are higher in one area than another. To optimize the ability to react, certain medications should be set aside into a safety stock to ensure that facilities have access even in shortage.
Using Omnicell's Pandora Financials software, pharmacy managers have access to the constantly changing ASHP drug shortage database through a new ASHP Item Shortage widget to help reduce time spent managing shortage items.
Long-term care clinical staff can proactively check this online database and obtain visibility on drug shortages. This way, caregivers and pharmacy managers who are faced with a drug shortage can work together to execute a plan of action and keep their patients safe and healthy.
Troy Hilsenroth is the vice president of vendor solutions for Omnicell, Inc.