National Pharmacy Week 2022: celebrating the important and impactful role of HCA Healthcare’s pharmacy teams

National Pharmacy Week is an opportunity for us to celebrate our pharmacy team members who raise the bar for patient care. It’s a time to recognize their powerful impact on patient lives and bring awareness to the vital role pharmacists, pharmacy technicians and other pharmacy colleagues play as part of the larger care team. As we celebrate National Pharmacy Week from October 16th to 22nd and Pharmacy Technician Day on October 18th, we express gratitude for their partnership in providing compassionate, connected care.

“Across HCA Healthcare’s hospitals, surgery centers and other sites of care, more than 7,000 pharmacy team members serve as critical contributors to our delivery of excellent patient care,” said Dr. Chenette Burks, HCA Healthcare’s director of medication management.

Pharmacy: integral to the care team

Safe, quality care doesn’t happen by accident; it must be embedded into an organization’s culture. Our pharmacy colleagues are indispensable to our care teams. In addition to how you imagine they contribute, they are responsible for overseeing medication event reporting, ensuring compliance with state and federal regulations, medication diversion prevention and more. These teams are responsible for monitoring clinical pharmacy surveillance software to make real-time medication interventions, identifying ways to prevent medication errors, reduce drug waste and improve patient outcomes.

Pharmacy colleagues support physicians and mid-level practitioners with medication optimization, offer pharmacy consultation for medication dosing and counseling, ensure appropriate monitoring of medications and help with important initiatives such as antimicrobial stewardship. They answer drug information questions from nurses and providers, collaborate on lab orders for medication monitoring and culture review, and work closely with dietary teams, respiratory therapists and many other members of the larger care team.

Meet our Centralized Order Entry Pharmacists

Centralized Order Entry (COE) Pharmacists work with facility-level pharmacists as another key part of the pharmacy and overall care team. Less visible than other pharmacy team members, COE pharmacists provide the first-line review for pharmacy orders in our health system. Upon receipt of an order, they review the patient profile and parameters and determine if a medication is likely safe and effective for that patient before the order is dispensed. While facility pharmacists focus on clinical interventions, preparing medications and ensuring pharmacy is represented in onsite care team work, COE pharmacists fill an equally important prescriptive and expanding role.

Erin Graden, PharmD, is the division director of Consolidated Pharmacy Services in Denver and oversees COE teams for HCA Healthcare’s Continental, Mountain and Far West Divisions. Joining the team nine years ago as a COE pharmacist, she eventually assumed roles as COE supervisor, director and now division director. With more than 600 COE colleagues across the organization, Erin oversees a team of 80 pharmacists in her divisions, where they maintain a laser focus on optimization, improvement and support… always asking what we can do better, how we can be more efficient, and how we can share best practices to improve care.

“When COE was put in place 15 years ago, it began with taking order entry workload off the facility pharmacist, and that’s where we helped enable growth in the clinical pharmacy role,” said Dr. Graden. “If you think about how far we have come, our COE team now is integral to our care team efforts around medication safety, tracking and trending errors, and effecting changes in our system as well as a national policy to prevent harm. Maintaining this culture of safety allows us to improve care quality at our organization and beyond continuously.”

The right dose of care

Chances are, you or someone you know has spent time in a hospital or healthcare environment where you received one of many medications managed by pharmacy teams. While medication management is an important job of everyone in the hospital and other healthcare settings, pharmacy colleagues lead the charge when it comes to medication safety.

Pharmacists and pharmacy technicians are responsible for the safe preparation and dispensing of medications, but also much more. They learn from errors (both internally and in the larger public realm) and make system-level changes, so they don’t happen again, as well as submit “good catches” to continuously contribute to a culture of safety.

HCA Healthcare’s Patient Safety Organization (PSO) works to improve patient safety and quality of healthcare by building systems, refining processes and fostering our culture of safety. It partners with pharmacy colleagues and other frontline experts to identify opportunities to openly discuss, analyze and act on patient safety concerns, and to conduct proactive risk assessments, investigations and improvement initiatives. The PSO partners with clinical experts to disseminate “Calls to Action” regarding significant concerns, and shares lessons learned from analyses of serious safety events in order to make improvements.

Importantly, our PSO supports transparent patient safety event reporting and associated investigation to encourage colleagues to openly report safety concerns in a way that is safe for them. This contributes to an environment committed to learning, protecting employees and advancing safer care for patients.

Medication safety in a learning health system

HCA Healthcare develops and employs best practices in medicine, using a scale to support learning and healthcare transformation systematically. With 182 hospitals and more than 2,300 sites of care, we harness the power of health data and information to support ongoing cycles of knowledge generation and transformative change. When it comes to medication safety, we have the ability to see safety issues at a greater scale than many health systems.

Our medication management teams can see if there are local issues at one hospital, a regional division issue or even a larger, national system-wide issue beyond our organization. This visibility allows us to leverage knowledge to care for patients not only in our organization but everywhere. For example, suppose there is a manufacturer safety issue with a medication that affects multiple health systems across the country. In that case, we may have the ability to pinpoint the issue more quickly than others and report it to manufacturers and federal agencies. As one of the nation’s largest healthcare providers, we view this as a social responsibility.

Carley Warren, PharmD, BCPS, CPPS, in her role as manager of medication safety at HCA Healthcare in Nashville, works with our PSO and others to advance medication safety for the organization.

“We are committed to being a learning health system, reflecting on new knowledge and insight while leveraging organizational expertise to establish the most effective and efficient medication processes,” said Dr. Warren. “Every patient deserves to feel safe in our care, and I am proud that we empower colleagues to provide safe patient care while also improving it.”

Dr. Warren shares that her work, and that of our pharmacy teams, helps address the nursing shortage by freeing them up to spend more time on direct patient care. She adds that they address medication management opportunities, redesigning processes and technology around medication management while always considering the medication safety aspects.

“Our medication safety advisory group of interdisciplinary team members meets regularly to understand challenges and best practices,” says Dr. Warren. “This team of experts from across our nationwide divisions includes quality leaders, pharmacy managers, nursing leaders, patient safety directors and more, and we learn not only from our own findings but also from external groups like the Institute for Safe Medication Practices (ISMP) to assess our practices and known healthcare industry risks. Pharmacy leaders are crucial in advancing medication safety work across the company to improve the care we provide, and we thank them for their important contributions to our mission.”

Heroes in healthcare delivery

Along with many pharmacy team colleagues who contribute to HCA Healthcare’s culture of safety, our pharmacy technicians are hidden heroes in delivering safe, quality care for patients.

Pharmacy technicians are responsible for inventory management, compounding services and other distributive tasks, but also collaborating on medication safety, regulatory compliance, controlled substance and diversion monitoring and more. They help ensure safe, accurate and appropriate procurement, receipt, storage, preparation, distribution and monitoring of pharmaceutical services and products. Among other things, they prepare and label IV admixtures and compounds, handle Pyxis medication filling and support, and lead supply management and inventory optimization.

While the focus for everyone on the pharmacy team is the patient, the pharmacy technician “customer” is the direct care provider, including physicians, nurses and other ancillary groups. Technicians provide a high level of customer service to pharmacists and these care team members, enabling them to do their jobs in support of excellent patient care.

Advancing the Pharmacy Technician profession

Ashley Snow, a pharmacy technician supervisor at HCA Healthcare’s Research Medical Center in Kansas City, is exemplary in her role as she continues to advance the profession, always learning and stepping up to the plate in times of short staffing to ensure the success of her team.

A registered pharmacy technician for 20 years, Ashley started in high school as a volunteer, eventually working in hospital pharmacies, retail, oncology outpatient infusion centers, and as an oncology pharmacy buyer for many years. She held roles in various capacities as PRN, seasonal as well as full-time. Now, as pharmacy technician supervisor at HCA Healthcare, she has more than 20 team members under her wing, working alongside pharmacy operations managers, technicians, buyers, interns and more.

“I tell my team members to learn all they can because the more you know, the more you can grow. When you become that go-to person, you become an asset and can advance in your role. When opportunities present themselves, you are on the front lines.”

Ashley adds that this certainly is true for pharmacy technicians because there are not yet standardized pathways to becoming a pharmacy technician, and there are differences in licensure and training requirements across state lines. She encourages technicians to know their strengths and to specialize to become subject matter experts. And she advocates that technicians working at the height of their licensure by choosing national certification opportunities lead to improved patient outcomes in the pharmacy big picture.

“There are many ways for pharmacy technicians to advance their careers, and to become involved in advocacy, including on committees and professional service boards,” said Snow, who is involved in the American Society of Health System Pharmacists (ASHP) and Pharmacy Tech Certification Board (PTCB). She also notes that acting as a technician liaison for state and local chapters of ASHP is a great way to network, learn and grow.

With gratitude to our pharmacy colleagues

In an extremely difficult season and past year for all of our pharmacy team members, we hope you feel appreciated by your communities, colleagues and patients. We recognize your invaluable role in patient care every day and know that healthcare delivery does not happen without you. Please know that we are grateful and see your contributions to our ability to care for all of us in times of need.

And thank you to all HCA Healthcare colleagues for your steadfast focus on providing the best possible care for our patients. We appreciate your partnership in this work and your commitment to the care and improvement of human life.