Adapting clinical pharmacy staffing models during the COVID-19 pandemic: Lessons learned and considerations for future disaster planning

ABSTRACT

Introduction: In response to the COVID-19 pandemic, healthcare institutions faced challenges that required operational agility to facilitate provision of optimal patient care. Research Question or Hypothesis: This research was performed to elucidate how pharmacy departments adapted their staffing models and the impact on frontline staff satisfaction. Study Design: Critical care pharmacists in ACCP and ASHP list-serves were electronically invited to participate in a 28-question survey in April/May 2020. Methods: Likert-like questions used a 1-5 (strongly agree to strongly disagree) scale, and responses were compared based on degree of satisfaction with pharmacy leadership strategies implemented. Practice model changes were compared before and during COVID-19. Multivariate logistic regression was used to assess the effects of independent variables on the primary outcome, satisfaction with pharmacy leadership response. Results: Respondents (N = 168) representing 40 United States participated. Forty percent of respondents experienced a surge, 68% experienced a staffing model change, and the majority (64.9%) were satisfied overall with their pharmacy leadership's response to the COVID-19 pandemic. Both specialists (50% vs. 21%, P = 0.013) and unit-based generalists (65% vs. 35%, P < 0.001) decreased rounding in the unit. Disagreement with “Satisfied with leadership efforts to protect staff (limiting in-person meetings, changing code response)” decreased the odds of satisfaction by 96% [Odds Ratio (OR) 0.043 (95% CI 0.005-0.336), P = 0.003). Disagreement with “Satisfied with voice of front-line staff” was associated with an 84% reduction in satisfaction [OR 0.165 (95% CI 0.049- 0.549), P = 0.003]. Eliminating inperson rounds associated with a 95% decrease in satisfaction with pharmacy leadership [OR 0.053 (95% CI 0.007-0.392), P = 0.004]. Disagreement with “I believe I am at increased risk of getting COVID-19 due to departmental staffing decisions (as compared to ICU peers in other institutions)” increased satisfaction [OR 3.8, 95% confidence interval (CI) 1.06-13.91]. Conclusion: Frontline staff perceptions can inform practice model changes to improve employee satisfaction while providing safe, reliable, and responsible patient care.