Drug Shortage

Four drug shortage imapcts

Financial Burden

Safety Concerns

Patient care compromise

Operational disruptions

Financial Burden impact on healthcare system

Costly alternatives

Hidden costs→Revenue loss from delayed or canceled procedures

Safety concerns impact on healthcare system

Prescribing unfamiliar alternatives

Pharmacists verifying fewer familiar meds

Nurses administering unfamiliar meds

Conversion miscalculations

Off-protocol practices with less guidance

Patient care compromise impact on healthcare system

Economic- increased costs for med

Clinical- Quality of life, more frequent hospitalizations,

Humanistic- more complaints, transfers, emotional impact

Operational disruptions impact on healthcare system

Pharmacy staff time spent communicating with manufacturers and calming down pts

Eight drug shotage tasks

Identification (Awareness)

Operational Assessment (Internal)

Clinical Assessment

Severity evaluation

Planning (Prep)

Implementation & Communication (Implementation & Eval)

Re-evaluation

Resolution

Identification examples

Notification to pharmacy buyer

Buyer→ Drug shortage team

Drug Shortage team→ Clinical pharmacy staff

Operational Assessment example

Assess severity of shortage

Determine impact on operational workflow

Develop alternative workflows

Evaluate resources

Clinical assessment example

Identify clinical alternatives for medication in short supply

Evaluate how to allocate limited resources

Security evaluation example

Assess alternative drugs, formulations and vial sizes available for $

Examine inventory to assess days supply on hand

Planning examples

Seek approval for med change

Modify clinical pathways

Deploy med in short supply until new one is procured

Create systems to monitor inventory

Identify and implement or adapt as ended specific clinical and operational strategies

Re evaluation examples

Review impact on patient care and work processes

Develop contingency plans if the shortage worsens

Monitor impact of the shortage to determine an end point

Assess if any unintended consequences have occurred