Why staffing is pharmacy leaders' No. 1 concern

As the three-day walkouts among CVS, Walgreens and Rite Aid pharmacy employees come to a close, hospital pharmacy leaders shared with Becker's their workforce concerns. 

From Oct. 31 through Nov. 2, workers at some retail pharmacy chain locations called in sick to protest working conditions they say are unsafe because of understaffing and an overburdening of expectations. The scope of the walkouts is unclear because they were organized through grassroots advocacy efforts rather than a union, but retail pharmacy chain leaders report minimal disruptions. 

If more walkouts happen — such as the centralized labor effort among CVS workers in Kansas City, which affected operations at 22 pharmacies — hospitals and health systems could face bottlenecks in discharging patients, according to Don Gruntowicz, PharmD. 

For instance, if patients are nearly ready for discharge but nearby pharmacies are closed after hours or on weekends, lengths of stay are prolonged and care to other patients can be delayed, he said. 

"There's a lot of focus on discharge efficiency. It's almost daily we hear that, 'discharge efficiency,'" said Dr. Gruntowicz, senior director of pharmacy services at Seattle-based Swedish Health Services. "Where do these patients get their prescriptions after hours if the closest 24-hour pharmacist is 10 or 15 miles away?"

As Rite Aid closes some stores during its bankruptcy process, CVS and Walgreens are continuing to shutter hundreds of locations — a trend that's concerning hospital pharmacy directors. 

"It's definitely going to cause a hiccup," Nilesh Desai, chief pharmacy officer of Baptist Health System in Louisville, Ky., said of pharmacy closures. "[It's] definitely a barrier from a patient care perspective."

Dr. Gruntowicz said access to care is a top-of-mind problem. Communities with fewer resources for healthcare could be hit the hardest, including rural areas without a mail-order pharmacy option, populations that can't afford primary care or urgent care, and patients who lack transportation to far-away pharmacies. 

Hospital and health system pharmacy leaders told Becker's they sympathized with the retail pharmacy workers who are participating in "pharmageddon," a moniker for the three-day walkout. 

"I can see why if they don't get a chance to do [what they have been educated and trained to do] and they're only focused on pushing drugs out the window, that they're not going to find that fulfilling," said Kuldip Patel, PharmD, senior associate chief pharmacy officer of Durham, N.C.-based Duke University Hospital.

In an early October poll conducted by Becker's, 460 respondents answered the question, "As a hospital pharmacy leader, what is your No. 1 issue at the moment?" Forty-five percent said "staff shortages." About a fourth selected "drug shortages," 28% chose "financial pressures" and 5% said "other."

Dr. Patel and Mr. Desai said frustrations among retail pharmacists have been bubbling up for years. They, along with Dr. Gruntowicz, said they're focused on retaining and engaging pharmacy staff inside their departments.

Anna Legreid Dopp, senior director of government relations at American Society of Health-System Pharmacists, echoed this as a priority among hospital pharmacy leaders across the U.S. 

In June, the ASHP, the American Pharmacists Association and the National Association of Boards of Pharmacy met to address solutions to high stress and workplace burnout among pharmacists across multiple care settings, from hospitals to independent pharmacies. The summit resulted in a 25-page report that recommends improvement in practice advancement, mental health, workforce support, regulations, and technology and workflow efficiencies.

Ms. Legreid Dopp said hospital pharmacy leaders are keyed in to bolstering their staff, both for their individual well-being and for patients. 

"At the end of all this, there is a patient that needs care," she said. "When the workforce is struggling, then there's a risk of patient care needs not being met."

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