Leadership and effective succession planning in health-system pharmacy departments.

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution's strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department's strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments.

Effects on patient care caused by drug shortages: a survey.

BACKGROUND: Drug shortages pose a serious challenge for health care institutions, often interfering with patient care. A common practice during a drug shortage is to select an alternate therapeutic; however, these agents often present challenges and may create safety concerns. Patient harms including adverse events and medication errors may occur. Patients may also file complaints because of drug shortages. OBJECTIVE: To measure the effect of drug shortages on patient outcomes, clinical pharmacy operations, patient complaints, and institutional cost. METHODS: An e-mail link to an online survey was sent to pharmacy director members in the MedAssets Pharmacy Group Purchasing Organization. Data were collected within a 3-week period from October 2-23, 2012. The survey focused on 6 different domains: demographics, adverse events, medication errors, patient outcomes, patient complaints, and institutional cost. RESULTS: The survey was sent to 1,516 directors of pharmacy. There were 193 respondents (response rate 13%) who participated in the survey. Approximately 40% of respondents reported between 1 and 5 adverse events probably or possibly associated with drug shortages at their institution. The majority of respondents reported between 1 and 10 medication errors. The most common types of medication errors reported were omission (n = 86, 55.5%), wrong dose dispensed/administered (n = 85, 54.8%), and wrong drug dispensed/administered (n = 54, 34.8%). The most common outcomes reported by respondents were alternative medication used (n=146, 85.3%), delay of therapy (n = 121, 70.8%), and increased patient monitoring necessary (n = 84, 49.1%). Patient complaints were reported by 38% of respondents. The majority of respondents reported an estimated quarterly institutional cost from shortages of less than $100,000, and approximately one quarter of respondents reported adding at least 1 full-time equivalent to manage drug shortages. The majority of participant comments mentioned the increasing institutional costs attributed to drug shortages. CONCLUSIONS: Medication errors and adverse events continue to occur from drug shortages, often resulting in inadequate patient care, high institutional costs, and patient complaints. Delayed care and cancelled care have been reported from shortages. Further research is necessary to better classify medication errors and adverse events during a drug shortage.