Boosting hospital performance by expanding pharmacy services

To optimize hospital performance, leaders must ensure their facilities remain on the cutting edge of clinical care, financial services and operational processes. Yet in today's challenging healthcare landscape, that might not be enough. Hospital leaders need to think outside the box and look at spaces traditionally overlooked in performance improvement initiatives. Pharmacy services are such spaces.

Pharmacies should be key partners for hospitals looking to improve not only medication management and costs, but also outcomes, patient experience and wider strategic goals, said Randy Davis, president and CEO of NorthCrest Health in Springfield, Tenn., during a recent Becker's Hospital Review webinar sponsored by Cardinal Health.

However, initiatives involving the pharmacy tend to be reactive. During the webinar, Michael D. Brown, vice president of managed services at Cardinal Health, cited a recent study the company conducted that found external market factors drive 50 percent of all new pharmacy-related initiatives.

NorthCrest Health decided to go against the grain and be proactive about integrating its pharmacy services more fully into the overall goals of the organization.

"We saw how many touch points that there could be with pharmacy, if we supported it," Mr. Davis said. "We had to make that decision and say, you know what, yes, it is important to have the rapid turnaround time on orders, it's important to find those cost saving opportunities — all those are important. Yet it's also important for the educational component for the patient and the staff and the doctors."

Overcoming the barriers to expanding pharmacy services
NorthCrest Health is a 109-bed, acute care, nonprofit hospital. Its leadership decided to make the pharmacy a key piece in its effort to improve hospital performance and patient experience. Hospital leaders realized they could positively affect key metrics, such as readmissions, just by having a pharmacist sit down with patients before discharge to deliver all the information they need to know about their medications.

However, there are barriers to these pharmacy-based care improvement interventions. On-site pharmacies can get bogged down by several factors, including increasing demands on their time. They may find it hard to sit down with patients and collaborate with medical staff, all the while ensuring that the back-end processes are being completed efficiently. Bringing in an outside pharmacy services partner can help overcome these issues.

"It isn't the easiest thing to do, in terms of building the program yourself and delivering it in a meaningful way through a standard employment model," Mr. Davis said. "So that is why we really consider pharmacy services as our partner [and] not try to do it ourselves. We understand that when you bring this bigger entity in, which solely focuses on the pharmacy aspect of our business, not only do you get the person on the ground with you, but what you're also getting is this broad-based organization behind them."

How pharmacy initiatives helped NorthCrest Health achieve its strategic goals
NorthCrest Health has two priorities: becoming a trusted advisor to patients and the communities they serve; and maintaining key strategic partnerships, including its formal affiliation with Nashville, Tenn.-based Vanderbilt University.

To help support these goals, NorthCrest partnered with Cardinal Health for pharmacy services, yielding multiple benefits for the health system:

1. Establishing a concierge service. Mr. Davis said that Cardinal Health helped NorthCrest become a trusted advisor in their community by creating a concierge pharmacy service, wherein each inpatient meets with a pharmacist before being discharged. During these visits, pharmacists explain medication changes, answer questions and let patients know what they should be talking to their primary care provider about after discharge.

"That hand-holding, that sitting-on-the-side-of-the-patient's-bed, looking in the patient's eyes … and making sure that good understanding exists, this is absolutely key to a concierge model," Mr. Davis said.

2. Supporting the rural healthcare community. Cardinal Health supported NorthCrest in its efforts to help rural healthcare providers improve the care they provide as well as establish antibiotic and opioid stewardship programs at rural facilities, Mr. Davis said.

3. Serving an intermediary with affiliation partners. Cardinal Health served as an intermediary between NorthCrest and Vanderbilt University, taking Vanderbilt's programs and processes and evaluating whether it would work in the community hospital setting of NorthCrest. They also helped the organization leverage its membership with the Tennessee Hospital Association, gaining access to grant opportunities and collaborative initiatives.

How to establish a center of innovation with your hospital’s pharmacy
Before organizations begin the process of evaluating their pharmacy workflow and services, Mr. Davis suggests taking two key steps:

• Creating a culture of innovation and fail-fast mentality to encourage new ideas and initiatives.
• Establishing multidisciplinary partnership and engaging pharmacy leadership in all hospital initiatives.

And finally, healthcare organizations must be open to making the changes that allow the pharmacy to play a greater strategic role within a hospital.

"We stepped back and looked at all of our initiatives, [and] we quickly saw that the pharmacy can play a key role," Mr. Davis said. "Give them a seat at the table and let them participate … In a nutshell, the steps we took were internal. They were rethinking our own previous approach of not involving pharmacy."

To learn more about Cardinal Health pharmacy services, click here, and view the full webinar here.





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