6 execs share the dangers of pharmacy burnout

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Pharmacy staff members across the country are reporting unprecedented levels of burnout, an issue that could not only negatively affect employees' mental health, but also patient safety. 

Here, six pharmacy leaders from health systems across the country detail the negative effects of pharmacy burnout.

Editor's note: Responses have been lightly edited for clarity and style.

Amanda Patel, PharmD. Director of Medication Safety, Quality and Accreditation at Providence (Renton, Wash.): Burnout can happen in any profession, but in the healthcare workforce it not only results in decreased productivity and higher rates of turnover, it can also lead to medication errors and increased patient harm. Although the prevalence and effects of burnout in physicians and nurses have been well-researched, this is a relatively new area of study in pharmacy staff.  

Burnout, which is characterized by emotional exhaustion, cynicism, depersonalization and a low sense of personal accomplishment, can affect pharmacists, pharmacy technicians, residents and even pharmacy students. A study published in 2018 by the American Journal of Health-System Pharmacy, revealed that 53 percent of the health system pharmacists surveyed reported a high degree of burnout. Causes of burnout, both personal (e.g., your health and the health of your loved ones, financial hardships, strained work/life balance) and professional (e.g., increased workload and administrative demands, significant drug shortages, heavy demands from electronic health records, insurance, and regulatory requirements) have been amplified during the current COVID-19 pandemic. 

The American Society of Health-System Pharmacists has partnered with the National Academy of Medicine as part of the Action Collaborative on Clinician Well-being and Resilience to develop toolkits and other free resources to support pharmacy staff that may be experiencing burnout. Individual caregivers can build resilience by monitoring their stress levels, connecting with a mentor, developing meaningful social connections and practicing daily gratitude.  

Caregiver well-being and patient safety are top priorities at Providence. We support clinician well-being and resilience by eliminating non-essential meetings and tasks during the pandemic allowing frontline caregivers to focus on their patients, helping caregivers connect to the organization's mission through conversations with leadership, sponsoring programming that recognizes the presence and risk of burnout, forming committees to explore the causing of burnout and implement resilience solutions, and celebrating positive improvements.

Kelley Curtis, PharmD. Chief Pharmacy Officer at St. Luke’s Health System (Boise, Idaho): It has been challenging keeping up with unpredictable volumes as hospital volumes increased to record highs. Some normal, non-direct patient care duties and projects for our pharmacy team have been paused to support the acute needs in our hospitals. We’ve also had the privilege of being able to support our nursing colleagues by standing up a dedicated clinic to administer COVID-19 treatment, managed by pharmacy personnel. 

Staffing shortages, especially in the area of pharmacy technicians, continues to be a challenge.  Our pharmacy team is tired, just like all healthcare professionals. We continue to shift pharmacy resources, when necessary, to help make the peak of this surge more manageable for those on the front line. Patient care and safety is always top of mind in all of our actions. We have not seen an increase in reporting of pharmacy errors or misses.  

Overall, while the environment today is far from ideal, we are managing, ensuring we keep our patients safe and meeting their medication needs.

Amanda M. Ball, PharmD. Clinical Manager of Clinical Patient Care Services at Duke University Health System (Durham, N.C.): While we continue to learn more and study the impact of pharmacist burnout on the profession and our patient outcomes, we have already learned that potentially high rates of burnout existed within pharmacies prior to the COVID-19 pandemic. Identified risk factors due to lack of resources dedicated to wellness, resilience and burnout and the demands within their job to feel rushed, constantly interrupted or having to divide their attention while trying to complete tasks have been linked to burnout, just to name a few. 

In addition, studies in healthcare workers have shown burnout has been linked to lower patient satisfaction scores, medical errors and medication errors. We have seen a higher self-reported rate of significant medical error and total number of medication errors in healthcare workers who are burned out. As we commit to care for our patients with an effort to reduce errors, improve patient safety and provide outstanding patient care services, the well-being of our pharmacy team must be part of that commitment. Ultimately, recognition of the signs and symptoms of burnout in our workforce along with factors leading to the development of burnout are vital to the support and stability of our workforce and the safety of our patients.    

Amir Emamifar, PharmD. Chief Pharmacy Officer at Temple University Health System (Philadelphia): Burnout is a growing concern across healthcare disciplines. Rates of burnout in clinical pharmacists are similar to those reported for other healthcare professionals. Burnout is associated with increased job turnover, decreased productivity and quality concerns, including both patient safety and satisfaction.

Strategies like enhancing communication, promoting true collaboration and community, addressing staffing shortages, empowering employee decision-making, and developing and promoting institutional values are helpful. Effective strategies should include both clinician, system-based initiatives and  best practices for addressing well-being include a multidisciplinary, multimodal approach with significant resource and leadership engagement.

Joel Hennenfent, PharmD. Chief Pharmacy Officer at Truman Medical Centers (Kansas City, Mo.): Supporting our team members is the highest priority. The pandemic has had a significant impact on pharmacy team members’ burnout and well-being across the country.  Healthcare team members are caring for sick patients that have higher acuity than we have seen before. Our staff are tired yet also picking up extra shifts to mitigate staff shortages and high patient load. Our staff need time off, although they feel guilty for doing so knowing that their colleagues will be short-staffed while they are away. 

A major contributor to burnout is the consistent effort required to maintain adequately trained staff due to turnover. This impacts our front lines as well as leadership who are constantly having to manage coverage and knowledge gaps where vacancies exist or new staff are training. The modern pharmacy enterprise has more sophisticated information technology and automation. This has dramatically increased the complexity and time needed to fully train a team member. It is critical for patient safety to have a rigorous and thorough training program.

Questions to ask your team — and listen closely: What is going well? What is one change that would improve your day-to-day activities? How can we reduce the complexity of work? What can we do to help?

It is essential that leaders create an environment where it is safe for team members to be authentic, transparent and vulnerable.

Gary Kerr, PharmD. Chief Pharmacy Officer at Baystate Health (Springfield, Mass.): In my opinion, the risks to patient safety do exist during this unprecedented, ultra-complex, day-to-day response to the pandemic, whether it be within the pharmacy space or with other front-line clinicians.

I'd quickly follow that up by saying there is also an unprecedented commitment to all aspects of pharmaceutical and medical care, at the department as well as the individual and multidisciplinary care team level. One example is the all-in pharmacy support of the COVID-19 immunization clinics for employees and patients. Another is our expanded offerings in the home prescription delivery space and the direct-to-patient well-being outreach and adherence calls.  These process improvements are actually sustaining and improving health and safety.

Keep in mind also, in the not so distant past, and to some degree today, there continues to be substantial dialogue surrounding the patient safety risks triggered by the U.S. drug shortages phenomenon. In both situations, there is so much innovative work being done at the system/organization level and also at the team/department level to modify work and responsibilities and there is explicit encouragement to seek professional well-being and resiliency support. 

Creative and impactful shortterm and long-term pharmacy strategies to manage through and ultimately improve the drug shortage challenges are evolving as well. At the national level, there is continued work to shift raw materials, active pharmaceutical ingredients and finished product sourcing to U.S. soil to close overseas supply chain gaps exposed by the Puerto Rico hurricane and now the global pandemic.

 

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