Hello friends, welcome back to my blog. Pharmacists play a crucial role in ensuring patient safety and proper medication management. I have been a pharmacist/pharmacy director since 2014. I started in the retail setting (Rite Aid) for about two and a half years prior to becoming a clinical pharmacist in the hospital setting. I also work in a long-term care pharmacy for about a year and a half as well. Currently, I am a pharmacy director for a small acute care hospital in southern California. I love this job because I get to deal with different problems every day. Today, I am going to share with you what a typical day of a pharmacy director is and the most common real-world challenges that I face every day.
What is a typical day for a pharmacy director?
I usually get to work at 8 am and leave at 5 in the afternoon. The director is a salaried employee, so I work Monday through Friday and am also on call. Luckily my team is very good at handling problems before it gets to me, so I barely receive any calls at night.
For the rest of the day, here is a general overview of what my day might entail
Morning Routine:
- The day might start with reviewing emails, messages, and any urgent issues that require attention. I often have 30 emails to look at.
- Briefly reviewing the day’s schedule and prioritizing tasks. We use Microsoft Outlook, and it does a good job of keeping my meeting organized.Â
Staff Management:
8 to 9:30 am: rounds with nurses and doctors to discuss each patient case.Â
9:45 to 10 am: Meeting with other leaders to discuss daily goals, assignments, and any concerns.
Providing guidance on pharmacy operations, staffing, and patient care protocols.
Operational Oversight:
- Monitoring medication inventory levels and making procurement decisions based on patient needs and budget considerations.
- Reviewing and updating pharmacy policies and procedures to ensure compliance with regulations and best practices.
- Addressing any operational challenges or workflow inefficiencies that may arise.
Collaboration with Healthcare Teams:
- Participating in interdisciplinary meetings with physicians, nurses, and other healthcare professionals to discuss patient care plans, medication management, and potential drug interactions. I typically have at least 5 to 6 meetings or training to participate every week. If I run a meeting, I have to spend more time preparing data for that meeting.
- Providing expertise on medication-related matters and suggesting adjustments to treatment plans as needed. Questions can come from nurses, doctors, or pharmacy staff.
Quality Assurance:
- When I play the pharmacist role, I review medication orders and prescriptions for accuracy, appropriateness, and adherence to formulary.
- Monitoring medication compounding and dispensing processes to ensure quality and safety. Our pharmacy compounds many IV meds, so we have to make sure they are correct before sending them out to the patient.
- Implementing strategies to reduce medication errors and adverse drug events.
Regulatory Compliance:
- Staying up-to-date with changes in state and federal regulations related to pharmacy practice.
- Ensuring that the pharmacy complies with all legal and regulatory requirements, including maintaining proper documentation and records.
Budget and Financial Management:
- Reviewing the pharmacy budget, expenses, and revenue generation. This has to be done daily because we want the charges to flow through as fast as possible without any delay. A delay could be: Lack of documentation, missing NDC, wrong account, …
- Identifying cost-saving opportunities without compromising patient care quality. Sometimes doctors order expensive meds for patients. We have to ensure that there is a justifiable reason by looking at the current formulary and comparing it with the new drug doctor wants.
Strategic Planning:
- Participating in strategic planning discussions to align the pharmacy’s goals with the healthcare institution’s mission.
- Identifying areas for growth and improvement within the pharmacy department.
Professional Development:
- Engaging in ongoing education and professional development to stay current with advances in pharmacy practice and healthcare management.
- Attending conferences, workshops, and seminars to network with colleagues and learn about emerging trends.
Emergency Preparedness:
- Ensuring that the pharmacy has a sufficient supply of essential medications in case of unexpected events. For instance, one of Pfizer’s manufacturing plants got hit by a tornado last week. Since Pfizer supplies 30% of the IV medication for the whole country, we had to manage to order more medication just in case shortage becomes an issue.
Meeting Administrative Duties:
- Completing administrative tasks such as performance evaluations, scheduling, and handling personnel matters.
- Reporting to higher management about the pharmacy’s performance, challenges, and achievements.
End of Day Review:
- Reflecting on the day’s accomplishments and identifying any tasks that need to be carried over to the next day.
- Checking in with key staff members to ensure that any outstanding issues are being addressed.
What can go wrong on a typical day of a pharmacist?
There are several scenarios where things can go wrong due to various factors. Some of these include:
Medication Errors: These can occur at various stages, including prescribing, transcribing, dispensing, and administering medications. Errors might involve the wrong medication, wrong dosage, incorrect patient, or incorrect route of administration.
Drug Interactions: Pharmacists need to be vigilant in identifying potential interactions between medications that a patient is taking. Failure to recognize and address these interactions can lead to adverse effects.
Allergic Reactions: Dispensing a medication to which a patient is allergic can lead to severe allergic reactions, which can be life-threatening in some cases.
Wrong Dosage: Providing incorrect dosages of medication can have serious consequences, ranging from reduced effectiveness to toxicity.
Labeling Errors: Improperly labeled medications can lead to confusion for both patients and healthcare providers, potentially resulting in incorrect administration. We have experienced these kinds of errors because there are so many drug vials that look alike. I am talking about the size of the vials, font, all the way to the color of the imprint.
Dispensing Incorrect Medication: Providing the wrong medication to a patient, even if it’s a similar-sounding or similar-looking medication, can lead to adverse effects.
Prescription Forgery or Fraud: Pharmacists need to be vigilant against fake or altered prescriptions that might be presented by individuals seeking unauthorized access to medication. This actually happens so many times in retail settings and mostly with narcotic prescriptions. For instance, a red flag that would be very easy to recognize would be a prescription for Norco 10mg/325mg written by a doctor from a location that is five hours away.
Inventory Management Issues: Running out of important medications or having excessive stock of others can disrupt patient care and create operational challenges.
Communication Breakdown: Inaccurate communication between healthcare providers, including physicians and nurses, can lead to misunderstandings about medication regimens.
Technology Failures: Reliance on technology for prescription processing and medication dispensing can lead to errors if there are glitches or malfunctions in the system. This is such a pain. Do you know when is the most common time
Lack of Quality Control: Inadequate quality control measures in compounding or preparing medications can lead to inconsistent dosages and compromised patient safety. USP797 is one of the strictest quality measures and regulations that the compounding area has to adhere to.
Ethical Dilemmas: Pharmacists may face situations where they have to balance patient care, legal requirements, and ethical considerations. Making the wrong decision can lead to ethical and professional dilemmas. Since our hospital doesn’t have an outpatient pharmacy, we can’t dispense medication for patients to go home with. There were a few times patients needed urgent medications prior to discharge, so we work with the local retail pharmacy to make sure the patient has their medication before we let the patient go home.
Lack of Patient Adherence: Even if pharmacists provide proper instructions, patients might not adhere to their medication regimens, leading to treatment failures.
Medication Shortages: Pharmacists may encounter situations where certain medications are in short supply due to manufacturing issues or other factors, requiring them to find suitable alternatives. Believe it or not, I have to deal with this on a weekly basis. Medication is constantly on backorder. It is very frustrating to not be able to get even the most basic medication in stock such as insulin or contrast.
To mitigate these risks, I adhere to strict protocols, engage in ongoing education, maintain open communication with healthcare teams, and continuously work to improve their practices and systems. Collaborative efforts between pharmacists, healthcare providers, and patients are essential to minimizing the chances of these potential issues.
