At many health systems, pharmacy leaders are often brought into infrastructure and operational planning after key decisions have already been made — a dynamic that can create downstream challenges for workflow, safety and efficiency.
For Melissa Chase, PharmD, director of pharmacy at Valley Children’s Healthcare in Madera, Calif., that timing is a persistent barrier. By the time pharmacy is included in a project, core elements such as space allocation, infrastructure needs and workflow assumptions are often already defined, leaving limited room for changes without adding cost or complexity.
“We often are not at the table from the very beginning of a project,” she said on the “Becker’s Pharmacy Leadership Podcast.”
The circumstance rarely is created intentionally, Dr. Chase said. Planning discussions often begin at a high level — focusing on building size, layout and major service lines — before ancillary functions such as pharmacy are fully considered. However, those early decisions can directly affect how medications are stored, compounded and delivered, as well as how technology and safety protocols are integrated.
In her role, Dr. Chase prioritizes early pharmacy involvement — not to change the scope of a project, but to ensure operational needs are incorporated before plans are finalized.
Once projects move forward, front-line staff provide some of the most valuable insights, she said. Pharmacists and technicians working in IV rooms and other critical areas bring practical knowledge that can surface issues not visible in early design discussions.
Her team has developed structured ways to incorporate that input, including reviewing architectural plans collaboratively and mapping workflows to test how spaces will function in practice. These exercises help identify inefficiencies, safety risks and workflow bottlenecks before construction is complete.
Dr. Chase also emphasized the importance of recognizing the limits of internal expertise, particularly in highly technical environments such as sterile compounding. Designing IV rooms requires specialized knowledge in areas such as airflow, pressure and regulatory compliance, often necessitating collaboration with external consultants.
“We didn’t go to pharmacy school to become HVAC technicians,” she said.
Technology decisions are another key component of these projects, but Dr. Chase cautioned against treating automation as a default solution. Instead, her team evaluates whether a tool improves safety, reduces risk or supports existing workflows.
If a system does not align with how staff operate, it is more likely to introduce friction than create value, leading teams to work around it rather than adopt it.
At Valley Children’s, automation investments have focused on improving both safety and staff experience, including the use of robotics and gravimetric systems in IV rooms. These tools help reduce repetitive tasks, minimize the risk of medication errors and support consistency in compounding processes.
Looking ahead, Dr. Chase sees growing potential in emerging technologies, particularly artificial intelligence, though she noted health systems are still in the early stages of understanding how to apply these tools safely and effectively in pharmacy operations.
Across these efforts, coordination across multiple teams remains critical. Pharmacy, IT, infection prevention, facilities, environmental services and construction teams all play a role, and missing input from any group can lead to delays, redesigns or operational challenges.
“These projects are never just pharmacy projects,” she said.
Preparing staff for change is equally important. New spaces and technologies require training, communication and time for teams to adapt. Without that transition planning, even well-designed systems can fall short.
“Never forget your front-line staff, they are some of your most important stakeholders,” she said. “They are the ones living in these spaces every day.”
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