Prevention and problem solving: in coronavirus fight, HCA Healthcare pharmacists emerge heroes

Since COVID-19 made landfall in the United States earlier this year, it has undoubtedly changed many aspects of our daily life. Meeting those challenges head on, HCA Healthcare caregivers and colleagues rose to the occasion by delivering innovative, patient-centered care for patients that count on them. Through it all, care excellence and patient safety remain top priorities, with HCA Healthcare’s pharmacy program playing a vital role in carrying out our mission.

In 2020, the work scope of clinical pharmacists has grown, similar to many clinical roles. During the COVID-19 pandemic, team members used their unique skillset to provide patient care strategies while mitigating medication shortages and supply chain disruptions.

From the onset of the virus in early spring, there were no FDA-approved treatments and, as a result, pharmacy teams served diligent detectives to find and share solutions. Throughout the COVID-19 response our health-system, the pharmacy services team employed a robust communication strategy to ensure the timely delivery of vital information, including:

• Daily team touchpoints were held in March and April to ensure urgent requests were completed.
• Pharmacy teams were aligned to maximize rapid turnaround for work product deliverables.
• Weekly leadership calls were conducted for each region of hospitals and for the broader health system.
• A resource hub was created on HCA Healthcare’s internal intranet, provider newsletters were distributed twice weekly.

Standing up and scaling these strategies was critical to optimizing medication therapy, protecting medication supply and reducing the number of staff entries to patient rooms, which ultimately has helped to conserve PPE. These strategies also helped limit time in patient rooms and reduce the exposure risk, conserve compounding supplies and promote medication safely.

The hard work our teams have put in to provide superior patient care during the pandemic, has carried over in how they continue to respond to the opioid epidemic in our country, which has seen a notable increase since the onset of COVID-19. According to a survey of over 170 hospital systems outside of HCA Healthcare, the COVID-19 Impact on the US National Overdose Crisis June 2020 Report found that for every 5 overdoses reported in May 2019, there were 7 overdoses reported in May 2020.

The severity of these increasing overdose numbers is concerning; however I am so proud of our pharmacy colleagues who remain steadfast in their dedication to serving our communities through ongoing efforts to combat the opioid epidemic.

As an organization, HCA Healthcare is using sustainable, interdisciplinary strategies when combating the opioid epidemic, which include engaging our communities, using data to drive clinical practice and optimizing the use of technology. Armed with three types of technology to optimize clinician communication and to minimize opioid overuse and diversion, electronic prescription for controlled substances (EPCS), prescription drug monitoring program (PDMP), and the Medication Adherence and Compliance Index (MACI), pharmacists are instrumental in this reduction effort.

• EPCS allows providers to electronically transmit controlled substance prescriptions to a pharmacy.
• The PDMP allows providers and pharmacists to quickly perform medication history checks and monitor real-time controlled substance data improving care, and preventing patient harm.
• MACI, which launched in the summer of 2020, is an electronic platform that aggregates data to aid in the prevention of theft of dangerous controlled substances.

While 2020 has presented its challenges, our pharmacy teams have met these challenges willingly and honorably. I look forward to continuing to work with these amazing colleagues across the organizations as the new Patient Safety Officer at HCA Healthcare, and I am excited to lead the expansion of our interdisciplinary, collaborative safety initiatives beyond the medication space to ensure that we continue to care like family for all of our communities.

We celebrate these large-scale accomplishments thanks to the work of our pharmacists throughout HCA Healthcare.

Thank you, for your dedication to serving others while upholding our values.

Karla Miller

Karla Miller, PharmD, BCPP, Chief Patient Safety Officer