Trust, technology, development lead to top of license practice
“Helping people to develop and grow is what I enjoy the most about being a leader.”
Stretching from the foothills of the Blue Ridge Mountains to the bedroom communities of the Washington, DC beltway, Betsy Early’s responsibilities are as diverse as the patient mix she and her teams serve.
On any given day, she oversees daily operations, leads standardization of services, and introduces transitional care protocols—while contending with crucial issues such as drug shortages, price spikes, and opioid addiction. Early trusts her staff has the confidence to take on these challenges because technology and professional development enables them to practice at the top of their licenses.
Q: What has been one of your toughest challenges over the past 18 months?
A: There are localities throughout Virginia that are struggling with the opioid situation—individuals, families, communities—just being ravaged by the opioid situation and the addiction issues associated with it.
As pharmacy leaders, opioid management is top of mind for us. We all play a role in how we manage the situation. Every time a patient comes into our facilities with pain issues, we want to be compassionate about managing pain because it’s one of the six vital signs. At the same time, we want to make sure we’re not perpetuating a situation that could lead to addiction and other downstream effects.
Q: How has the volatility of the drug supply chain impacted your area?
A: A prime example is when Hurricane Maria swept through Puerto Rico. It plunged the supply chain into complete chaos, and we were dealing with a ton of drug shortages, particularly IV bags.
We had to be really creative in obtaining and distributing medications. One of the key things we did was to leverage our health system buying power. Across Sentara, we all worked together to negotiate with the drug manufacturers and distributors to help us get the medications needed for our patients while they were in limited supply. It’s a lot harder to get their attention when you’re a standalone hospital.
We’re still dealing with sporadic shortages of critical medications. In today's world, maintaining the supply chain has become something that is always on your radar screen.
Q: What clinical adjustments did you make to account for the IV bag shortages?
A: At the same time we were managing the supply chain, we looked to change prescribing patterns and administration methods. And for help in doing this, we looked to maximize our relationships with our nursing staff and our physician staff. We needed them to understand what was happening and why we needed to make the necessary changes. Getting their buy in and support was critical.
So after reviewing the literature to make sure we were still getting the anticipated outcomes, we switched some patient therapies from IV infusions to IV push. This made us less reliant on IV bags, which were one of the biggest items impacted by the hurricane.
Q: How have you been able to withstand these types of challenges?
A: It’s because our team—pharmacists, technicians, and managers—all have stepped up and contributed to get us to good outcomes. Each group is a vital and key component of our team.
One overarching principle we’ve tried to follow is to maximize our staff, their abilities, and their scope of practice. We want to make sure we’re using pharmacists at the top of their license and involving them when developing overall system initiatives. We want to maximize technicians in the distribution functions, and give managers the independence to make the best decisions in the situations they face.
A big part of our ability to manage a challenge is having the staff understand that we’ve been through crises before. Each situation is a little bit different. But knowing that you've been through other things before together as a team boosts that confidence that we'll get through it, whatever the next crisis is.
Q: What role has technology played in your team’s confidence?
A: The role of the pharmacy technician truly has evolved and become a key component of our practice. Technology has accelerated that change. Technicians are managing the automation, managing pharmacy inventory, developing technology skills needed to keep the distribution processes going efficiently, and taking on a greater role in transitions of care programs.
When you have technicians practicing at the top of their license, then you can have your pharmacists also practicing at the top of their licenses and being more involved in the clinical services we provide to our patients.
Q: What types of patient interactions are your pharmacy technicians doing?
A: They’re taking on a greater role in transitions of care programs, such as performing admission med history. In some facilities, they’re also doing a lot of post-discharge follow-up. This role requires a unique skill set that some technicians have and some don't. If technicians want to pursue this role, we will work with them to develop that skill to help them be successful.
The best med history technicians understand the medication process and are great communicators. They develop a relationship with the patient. They have the ability to understand what is prescribed, and how to extract information from the patient to understand if they are taking the medication correctly or why a medication isn’t being taken. Is it because of side effects? Or is it because of cost or insurance issues? Or is it because the patient didn’t understand directions?
There are so many more opportunities today for pharmacy technicians to train and become certified in specialized areas. I encourage them to take advantage of those opportunities to enhance their skill set and to advance in the profession.
Q: Why do you prioritize professional development?
A: Developing people is the one of the most important things we do as leaders. I believe in developing the person, not necessarily the title. I look for opportunities to help with professional growth in all areas of the department, whether they be a manager, pharmacist or pharmacy tech, inventory manager, or have any skill set.
My perspective is, if people are taking the initiative to improve their lives, to better themselves, to make themselves more marketable and more valuable to the organization, I’m going to do whatever I can to support them.
I think helping people to develop and grow is what I enjoy the most about being a leader.