The role of the chief pharmacy officer in leading analytics strategy to support the enterprise

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Evaluation and Enhancement of a Comprehensive Controlled Substances Management Process at an Academic Medical Center

PURPOSE

Controlled substances management is highly regulated, and requires institutions to have processes in place to maintain a closed-loop. This study was conducted to comprehensively evaluate the current state of controlled substances management, propose optimization opportunities, and implement steps to align the medication use process (MUP) to a defined desired state.

METHODS

This evaluation was conducted in 2 phases. In phase 1, the current state of controlled substances management was assessed in order to develop a gap analysis tool and failure mode and effects analysis (FMEA). In phase 2, a work group was assembled to address opportunities within the FMEA. The work group prioritized opportunities using the risk priority number (RPN), and formulated action steps to align processes with the defined desired state.

RESULTS

Through the literature evaluation, a desired state, consisting of 86 segments, was defined and compared with a gap analysis tool. Direct observation of the MUP allowed for development of 13 process maps depicting current state. Of the 86 segments, it was determined the study institution had a compliance rate of 62%. The remaining 38% correlated with 55 actionable process opportunities that were included in the FMEA. To date, 31 of the 55 (56%) opportunities have been successfully addressed by the work group.

CONCLUSION

Use of direct observation to formulate a gap analysis tool and FMEA is an effective modality to evaluate controlled substances processes. These tools allow for pharmacy departments to identify and prioritize opportunities to optimize controlled substances management within an academic medication center.

Creating a Pharmacy Internship: A Toolbox for Success

Objective:

To describe available compensated student internships and provide guidance for new program development.

Methods:

A search was conducted using PubMed, MEDLINE, and Google with the following search terms: pharmacy, intern, internship, and student. All English language publications were considered for inclusion. Articles describing IPPE or APPE student utilization were excluded.

Key findings:

Pharmacy student internship programs are common in practice, though there are few with published outcome data. Most often, interns serve as pharmacist extenders and participate in activities that center around extension of pharmacy services within the institution. Development of new programs should include partnering with nearby pharmacy programs and state boards of pharmacy to develop a well matched curriculum and allow for interns to practice at the top of their license. Lastly, outcomes should be measured and disseminated for the benefit of the academy. Additional considerations for developing a student internship program and guidance are provided.

Conclusions:

Although in existence for decades, minimal published reports showcase institutional outcomes associated with student internships. No data is available to show the downstream effect an internship can have on direct patient care activities.

Housing and income effects on HIV-related health outcomes in the San Francisco Bay Area - findings from the SPNS transwomen of color initiative

Transwomen of color are disproportionately impacted by HIV and may have worse health outcomes than other populations. This analysis was conducted to examine structural factors associated with poor health outcomes among transwomen of color living with HIV in the San Francisco Bay Area (N = 159). Univariate and multivariable analyses were conducted to determine if structural factors were associated with poor HIV-related health outcomes. A majority of participants were Black or African American (110/159, 69.2%), 32 (20.1%) identified their primary race/ethnicity as Hispanic or Latino/a or Spanish, and 17 (10.7%) identified as another race/ethnicity. Transwomen of color in our sample faced extreme structural barriers, including residential transience, extreme low income, high prevalence of running out of money in the last six months, high rates of food insecurity, high prevalence of income via entitlement programs, engagement in sex work and other illicit activities for income. Unstable housing was the structural factor most consistently associated with poor health outcomes along the HIV care continuum and may explain engagement in other sources of income generation. Interventions are needed that go beyond the individual and health care-level to address needs for housing and economic opportunities to improve HIV care outcomes among transwomen of color living with HIV in the San Francisco Bay Area.