March 30, 2020

We Will Get Through This

John Feucht
System Director of Pharmacy Services, 
Summa Health

Overall, I cannot say enough about the members of this organization, from leadership to front line, we are preparing as best as we can and folks’ hidden talents are beginning to show. The support of this community has been amazing. Together we will get through this and, I feel, emerge as a stronger and closer-knit organization. Here are my answers to common questions:

What Steps Are You Taking...From a Staffing, Supply Chain and Resources Standpoint?

First off, the hospital has been operating under the Hospital Incident Command Structure since beginning of March.  Pharmacy is assigned positions in the Operations and Logistics sections of this structure.

Staffing

  • Staff temperature screening being done prior to building entry
  • Staff no longer entering patient rooms in order to conserve PPE  
  • Patient interaction done telephonically for education and transitions of care  
  • Looking into telehealth platform
  • Meds to Beds payment being taken via telephone. Medication delivered to the unit by a technician and handed to the nurse. This reduces need for patient to stop multiple places
  • Curbside delivery and mail order utilizing specialty pharmacy capabilities available to minimize hospital traffic
  • Anticoagulation visits being held virtually. Drive thru testing being considered
  • Staff in clinics being redeployed to other areas of the hospital through labor pool established by incident command
  • Work from home options for high risk employees or remote order verification from alternate sites if multiple facilities to promote social distancing
  • Communicate to all staff at shift change via remote huddles. Staff are anxious, worried, and scared. They want to help and want to know what is going on and leaders need to be visible
  • Allow cloth masks
  • Child care resources

Supply Chain

  • Coordinated effort by Clinical and Operational Staff to determine needed drugs and create pathways and order sets for medications
  • Leverage relationships with vendors for direct orders and other supplies
  • Common Canister MDI strategy with Respiratory Care
  • Patient Own Medication Policy
  • P&T emergency restrictions on medications as necessary due to drug availability
  • PPE Conservation measures in the clean room, negative pressure units (allow nurses to restock ADC)

Resources

  • Partner with the community for needs
    • Distillery for hand sanitizer
    • Community groups for sewing masks and caps
    • Other industries for N95 masks, face shields, gowns, gloves, etc
    • Employees have connections - leverage them
    • Vendor relationships (IT, automation, GPO)

What’s Working Well?

  • Good attitude
  • Teamwork
  • Community and Vendor Support

What Struggles Do You Face?

  • Drug shortages
  • PPE shortages
  • Keeping communication consistent across multiple campuses
  • Lack of enough automated equipment for surge units
  • Public Health cannot meet the need
  • 340B regulations
  • Vendors that appear aloof to the situation just trying to sell a product/service

Where Do You Need Help?

  • Drug shortages
  • What if a staff member develops COVID-19
  • Subject matter experts
  • Someone with a crystal ball

DISCLAIMER

The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.