Latest / Pharmacy Podcast Network / Talking Medication Safety in Specialty Pharmacy with ISMP | NASP Specialty Pharmacy Podcast

Transcript

Talking Medication Safety in Specialty Pharmacy with ISMP | NASP Specialty Pharmacy Podcast · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession.
• 0:10
  Speaker 2: Welcome to the Pharmacy Podcast Network.
• 0:26
  Speaker 3: You're listening to the nasp specialty pharmacy podcast a collaboration
• 0:31
  Speaker 3: between the national association of specialty pharmacy and the pharmacy
• 0:35
  Speaker 3: podcast network each episode dives deep into trends challenges innovations
• 0:40
  Speaker 3: and patient-centric practices shaping the future of this dynamic and
• 0:44
  Speaker 3: rapidly evolving industry whether you're a pharmacist or healthcare provider
• 0:49
  Speaker 3: patient advocate or industry leader You'll hear expert insights, real-world evidence,
• 0:54
  Speaker 3: and thought-provoking discussion that highlights all that makes specialty pharmacy special.
• 1:00
  Speaker 4: In support of NASP's mission to empower specialty pharmacy stakeholders
• 1:04
  Speaker 4: to advance the standard of patient care, NASP supports a
• 1:08
  Speaker 4: free market healthcare system in which all specialty pharmacies compete
• 1:11
  Speaker 4: on the same fair and level playing field. because that
• 1:14
  Speaker 4: is in the best interest of the patients we collectively serve.
• 1:17
  Speaker 4: NASP is committed to working with all stakeholders and policymakers
• 1:21
  Speaker 4: to ensure that all patients have access to the life-saving
• 1:24
  Speaker 4: medications they need and the high-touch patient care and support
• 1:27
  Speaker 4: services they deserve from the pharmacy of their choosing.
• 1:29
  Speaker 1: Hello, my name is Sheila Arquette, and I am the
• 1:32
  Speaker 1: president and CEO of the National Association of Specialty Pharmacy.
• 1:36
  Speaker 1: I am delighted to welcome my special guest, Dr. Rita Ju,
• 1:39
  Speaker 1: to this episode of the NASP podcast. Dr. Rita Ju
• 1:43
  Speaker 1: is president of the Institute for Safe Medication Practices, or ISMP,
• 1:48
  Speaker 1: where she leads national efforts to prevent medication errors. She
• 1:52
  Speaker 1: brings more than 25 years of advancing medication safety and
• 1:55
  Speaker 1: pharmacy operations, guiding hospitals through automation, sterile compounding, and clinical transformation.
• 2:02
  Speaker 1: She has held various leadership possessions, including director of pharmacy
• 2:06
  Speaker 1: at UCSF Health, Executive Director of Pharmacy and Clinical Nutrition
• 2:10
  Speaker 1: Services at CHOC Children's, and Clinical Manager at Children's Hospital
• 2:16
  Speaker 1: of Philadelphia. Her expertise spans medication safety, pharmacy operations, healthcare
• 2:21
  Speaker 1: technology and automation, and pediatric pharmacy services. A widely published
• 2:27
  Speaker 1: author and sought-after speaker, Dr. Ju has presented extensively on
• 2:30
  Speaker 1: clinical pharmacy topics and held adjunct faculty appointments at multiple
• 2:34
  Speaker 1: schools of pharmacy and nursing. She earned her PharmD from
• 2:37
  Speaker 1: the University of California, San Francisco, completed her residency at
• 2:42
  Speaker 1: Thomas Jefferson University Hospital, and holds an MBA from the
• 2:45
  Speaker 1: Wharton School at the University of Pennsylvania. She is a
• 2:49
  Speaker 1: board-certified pediatric pharmacy specialist. Rita, thanks so much for joining
• 2:53
  Speaker 1: me today. Of course.
• 2:56
  Speaker 2: It's my pleasure to join you here.
• 2:59
  Speaker 1: So many of our listeners may have heard of ISMP,
• 3:02
  Speaker 1: but may not know much about the organization. Can you
• 3:05
  Speaker 1: tell us who is IMP and what is its mission?
• 3:08
  Speaker 2: Of course, yes.
• 3:09
  Speaker 5: ISMP stands for the Institute for Safe Medication Practices. We
• 3:14
  Speaker 5: are an independent nonprofit organization that is devoted entirely to
• 3:20
  Speaker 5: medication safety. And then in 2020, we became part of ACRI,
• 3:25
  Speaker 5: which is another nonprofit organization that is more focused on
• 3:28
  Speaker 5: patient safety in general and device safety. Our mission is
• 3:34
  Speaker 5: very simple, but powerful. It is advancing patient safety worldwide
• 3:40
  Speaker 5: by empowering the healthcare community to prevent medication errors. We
• 3:45
  Speaker 5: are founded and rooted in medication error reporting. For more
• 3:50
  Speaker 5: than 30 years, ISMP, through our medication error reporting program,
• 3:56
  Speaker 5: has identified medication use risk. And then we analyzed a
• 4:01
  Speaker 5: lot of these errors that came into our reporting portal
• 4:06
  Speaker 5: and then helped develop practical strategies to help prevent patient harm.
• 4:12
  Speaker 5: So really collecting and analyzing the medication error report is
• 4:18
  Speaker 5: just one big thing that we do, but we then
• 4:21
  Speaker 5: publish these kind of learnings in our newsletter. We also
• 4:26
  Speaker 5: share these information through educational programs with healthcare professionals. And
• 4:32
  Speaker 5: most importantly, what we do is we collaborate with our stakeholders,
• 4:36
  Speaker 5: whether it's healthcare organizations or pharmaceutical industry or even the
• 4:43
  Speaker 5: government agencies or accreditation agency to help them implement safe
• 4:48
  Speaker 5: medication use practices.
• 4:50
  Speaker 2: And so throughout the work.
• 4:52
  Speaker 5: That we do, we are all about advocating for safer
• 4:55
  Speaker 5: medication use systems. And then our biggest thing is that
• 5:01
  Speaker 5: we are unique in the sense that we focus on
• 5:06
  Speaker 5: understanding why errors happened and then offering practical solutions to
• 5:12
  Speaker 5: help organizations, redesigning the systems to make things safer. And
• 5:17
  Speaker 5: then in the last five years, we really have placed
• 5:20
  Speaker 5: more focus on the ambulatory care settings, including community and
• 5:25
  Speaker 5: specialty pharmacies, just because as we all know, more and
• 5:29
  Speaker 5: more care is moving to the ambulatory settings.
• 5:33
  Speaker 1: Yeah, I remember when I was practicing a long, long
• 5:35
  Speaker 1: time ago, I remember a couple campaigns that came out
• 5:38
  Speaker 1: of analyzing medication errors, like the lookalike, soundalike, right? The
• 5:41
  Speaker 1: ways to try to make sure you're dispensing the right medication.
• 5:45
  Speaker 1: And this is before e-prescribing, but then writing out some of,
• 5:48
  Speaker 1: you know, the common abbreviations, right? Like units and milligram
• 5:51
  Speaker 1: and things like that so that there weren't errors made
• 5:54
  Speaker 1: like that.
• 5:56
  Speaker 2: Yep, definitely. That's what we're all about.
• 5:58
  Speaker 5: A lot of those items that you talked about, guidelines
• 6:01
  Speaker 5: and tools that ISMP published to try to improve.
• 6:05
  Speaker 2: The system and make things safer. Yeah.
• 6:08
  Speaker 1: So tell me why medication safety should be a top
• 6:10
  Speaker 1: priority in the specialty pharmacy practice setting.
• 6:14
  Speaker 5: Well, I think a lot of people think about specialty
• 6:16
  Speaker 5: medications and they think high cost. I think specialty medications
• 6:21
  Speaker 5: is not, besides the high cost, it also.
• 6:25
  Speaker 2: has a lot of risk involved in that. So it's
• 6:28
  Speaker 2: also a high risk medication and process in a lot
• 6:33
  Speaker 2: of ways, right? Medications these days, a lot.
• 6:37
  Speaker 5: More potent drugs than when I was in school. I
• 6:41
  Speaker 5: still remember when I first started practice, everyone will tell
• 6:44
  Speaker 5: you oral medications are not going to be killing people.
• 6:47
  Speaker 5: So meds that patients are taking in general from the
• 6:52
  Speaker 5: Community pharmacies, less likely.
• 6:55
  Speaker 2: To cause harm. It's no longer the case in here, right?
• 6:58
  Speaker 5: And more and more of these specialty medications also have
• 7:02
  Speaker 5: a lot of drug interactions. They may have narrow therapeutic
• 7:06
  Speaker 5: index or very complex dosing. We've seen a lot of those.
• 7:10
  Speaker 5: And all this means is these high complexity drugs, really requires.
• 7:16
  Speaker 2: Specialized handling and onboarding.
• 7:20
  Speaker 5: And a lot of times it's also ongoing monitoring and
• 7:23
  Speaker 5: patient support. And Coupled with this complexity is also the workflow.
• 7:31
  Speaker 2: Of specialty pharmacy.
• 7:32
  Speaker 5: I don't think I need to belabor this with the
• 7:35
  Speaker 5: audience for this podcast, the fact that the specialty pharmacy
• 7:39
  Speaker 5: workflow is very complex, includes prior authorization, co-chain management, dispensing, shipping, administration, coordination,
• 7:48
  Speaker 5: detailed patient education, and on and on, right? I guess
• 7:52
  Speaker 5: the The problem is every single one of these steps,
• 7:56
  Speaker 5: an error could happen that can result in patient harm.
• 8:00
  Speaker 5: And that's why we believe that specialty pharmacies can also
• 8:09
  Speaker 5: work on building a reliable system that is consistently safeguarding
• 8:15
  Speaker 5: against human errors. That's what ISMP is about, and that's
• 8:19
  Speaker 5: what we believe. In the specialty pharmacy world, this is
• 8:23
  Speaker 5: a high priority thing to help protect patients receiving these
• 8:28
  Speaker 5: very complex medications.
• 8:31
  Speaker 1: Now, the patients themselves are oftentimes complex, right, and very vulnerable.
• 8:35
  Speaker 2: Absolutely. And the environment they are in.
• 8:40
  Speaker 5: The whole environment they are in is also something that
• 8:43
  Speaker 5: we need to take into.
• 8:44
  Speaker 2: Consideration, right?
• 8:45
  Speaker 5: Because when you're in the hospital, you know you have
• 8:48
  Speaker 5: a set environment. But when you're shipping drugs out to
• 8:52
  Speaker 5: patients who potentially could be living in very different conditions,
• 8:56
  Speaker 5: whether they have refrigeration or not, if this is a
• 8:59
  Speaker 5: refrigerated medication, are all important items to consider.
• 9:05
  Speaker 2: Absolutely.
• 9:06
  Speaker 1: I tell people this all the time because I think
• 9:09
  Speaker 1: you're right. There is that misconception that just because it's
• 9:11
  Speaker 1: a pill, it can't hurt you. I'm like, we're treating
• 9:13
  Speaker 1: people now with cancer medications in their home and without
• 9:18
  Speaker 1: any real healthcare provider interaction like they would have had
• 9:21
  Speaker 1: 10 or 15 years ago had they gone into a
• 9:23
  Speaker 1: clinic or the doctor's office, an infusion center. I think
• 9:27
  Speaker 1: you're right. The propensity for something to go wrong is high.
• 9:31
  Speaker 5: Right. The fact that a lot more these days, patients
• 9:36
  Speaker 5: are self-injecting medications at home, right? And making sure that
• 9:40
  Speaker 5: they understand how to drop the right dose if they
• 9:43
  Speaker 5: have to do that and how to make sure that
• 9:48
  Speaker 5: they are injecting the medication in a sterile manner, that
• 9:53
  Speaker 5: they're not contaminating things and causing themselves an infection.
• 9:57
  Speaker 2: Those are all important items that they need to get
• 10:01
  Speaker 2: educated and we need to ensure that they actually understand
• 10:05
  Speaker 2: that not just we we are delivering that education but
• 10:09
  Speaker 2: getting reassurance that they can handle the complex therapy is important.
• 10:15
  Speaker 1: Absolutely What are some of the most common medication safety
• 10:18
  Speaker 1: challenges ISMP sees across specialty pharmacy practice?
• 10:23
  Speaker 2: Well, a lot of the.
• 10:24
  Speaker 5: Risks that we see in specialty pharmacy practice is similar
• 10:28
  Speaker 5: to those found in other areas in healthcare or just
• 10:32
  Speaker 5: inpatient practices, like communication breakdowns, workflow interruptions, technology issues, all
• 10:40
  Speaker 5: the the failure to properly utilize or implement technology, and
• 10:46
  Speaker 5: human factors vulnerabilities are all similar in that setting. However,
• 10:52
  Speaker 5: specialty pharmacies definitely face additional challenges because a lot of
• 10:58
  Speaker 5: them are new therapies that are entering the market. They
• 11:01
  Speaker 5: have very complex dispensing processes.
• 11:03
  Speaker 2: We talk about those all the time.
• 11:05
  Speaker 5: Every time when a new specialty medication is ready to
• 11:08
  Speaker 5: come out, the ISMP team started looking into that and
• 11:12
  Speaker 5: talking through some of these complexity with dispensing processes.
• 11:15
  Speaker 2: They may be.
• 11:15
  Speaker 5: Different payer requirements and coordination just depends It really does
• 11:19
  Speaker 5: require coordination across multiple providers and multiple care settings.
• 11:26
  Speaker 2: And that adds to the challenge.
• 11:29
  Speaker 5: And in addition to that, these days we are also
• 11:33
  Speaker 5: hearing about some accreditation agencies or payers' requirements that require
• 11:41
  Speaker 5: specialty pharmacies either monitor or monitor report medication errors rate.
• 11:47
  Speaker 5: And that is one area that ISMP is very passionate about.
• 11:52
  Speaker 5: We discourage benchmarking or trending of medication error rates, mainly
• 11:58
  Speaker 5: because in our current system, in our healthcare system, all
• 12:03
  Speaker 5: of these error are voluntary reports. So I oftentimes tell
• 12:10
  Speaker 5: people who are really into medication error rates, To say,
• 12:16
  Speaker 5: to basically tell them.
• 12:17
  Speaker 2: You know, if you want, if you really think that
• 12:19
  Speaker 2: a low.
• 12:19
  Speaker 5: Medication error rates is a good thing, all you have
• 12:22
  Speaker 5: to do is to tell people to stop reporting and
• 12:24
  Speaker 5: you'll have zero errors.
• 12:27
  Speaker 2: That is not good, right?
• 12:28
  Speaker 5: Because we advocate for building a strong culture of safety
• 12:33
  Speaker 5: and that is is hand in hand with encouraging reporting
• 12:37
  Speaker 5: of errors and near misses, because that's how we can
• 12:41
  Speaker 5: identify and reduce risk, right? If we don't know about something,
• 12:45
  Speaker 5: we just kind of put our hands on our eyes
• 12:47
  Speaker 5: and say, I don't want to see it, or our
• 12:50
  Speaker 5: hands on our ears and say, don't want to hear
• 12:52
  Speaker 5: about it, because that affects our metrics of error rate.
• 12:58
  Speaker 5: Then we'll never learn about what are some of the
• 13:01
  Speaker 5: existing risks that we can work on preventing, right?
• 13:04
  Speaker 2: So we really.
• 13:06
  Speaker 5: do have to look beyond these error rates and focus
• 13:10
  Speaker 5: on systems vulnerabilities and looking at these close calls. Hopefully
• 13:15
  Speaker 5: they are close calls and not actual errors that happen
• 13:18
  Speaker 5: to a patient. And really use that as opportunities for
• 13:23
  Speaker 5: process improvement. So I think I have not, as we
• 13:26
  Speaker 5: have been working in medication safety for quite a long
• 13:30
  Speaker 5: time now, we have chipped away this whole notion that
• 13:35
  Speaker 5: people have on medication error rates and, you know, lower
• 13:39
  Speaker 5: rate is better.
• 13:40
  Speaker 2: And now we're coming into a new space where people
• 13:44
  Speaker 2: have been talking about medication error rates and wanted low rate.
• 13:48
  Speaker 2: And so that is a challenge that we kind.
• 13:53
  Speaker 5: Of want to work with specialty pharmacies to overcome as well,
• 13:56
  Speaker 5: because that is important to build a very strong culture
• 14:00
  Speaker 5: of safety and eventually a process improvement.
• 14:04
  Speaker 2: Sure.
• 14:06
  Speaker 1: So shipping and delivery are critical components of specialty pharmacy care.
• 14:10
  Speaker 1: What has ISMP learned about shipping and delivery errors and
• 14:13
  Speaker 1: what can organizations do to reduce their risk?
• 14:17
  Speaker 5: What we learned is shipping and delivery errors are very common.
• 14:22
  Speaker 5: As a matter of fact, we are currently working on
• 14:25
  Speaker 5: an article in our ambulatory and community newsletter called And
• 14:30
  Speaker 5: one of the specialty pharmacies shared with us that shipping
• 14:33
  Speaker 5: and delivery related errors accounts for almost half of the
• 14:39
  Speaker 5: internally reported errors.
• 14:41
  Speaker 2: That is surprising.
• 14:44
  Speaker 5: That's kind of scary because if you have made errors
• 14:47
  Speaker 5: in delivery, that could have a huge impact. So anywhere
• 14:51
  Speaker 5: from patients receiving the wrong medications to medications getting shipped
• 14:56
  Speaker 5: to the wrong address or just delay in the delivery
• 15:00
  Speaker 5: or in patients getting their therapy or missed doses are
• 15:04
  Speaker 5: all common things that we see.
• 15:06
  Speaker 2: And as we're looking at some of the.
• 15:08
  Speaker 5: Contributing factors, I think this is where things get really complex.
• 15:13
  Speaker 5: In a regular community pharmacy, when patients are coming in
• 15:16
  Speaker 5: to pick up their medications, you have your store to
• 15:20
  Speaker 5: worry about that you can create processes. So there is
• 15:24
  Speaker 5: internal system-based processes that we need to make sure that
• 15:27
  Speaker 5: the right patient is picking up the right medication. When
• 15:30
  Speaker 5: you're shipping this out, you do have to deal with
• 15:32
  Speaker 5: internal systems, which It's complex because we've seen how work
• 15:38
  Speaker 5: is being done in specialty pharmacies, anywhere from it could
• 15:42
  Speaker 5: be in just not confirming.
• 15:47
  Speaker 2: The current patient.
• 15:48
  Speaker 5: Address to the fact that you may have the right
• 15:51
  Speaker 5: patient address, but somehow if the systems are not connected,
• 15:55
  Speaker 5: that you still ended up coming out with a packing
• 16:00
  Speaker 5: label for patients. or delivery label that has the wrong
• 16:04
  Speaker 5: address on it. There's all kinds of issues, internal system-based
• 16:08
  Speaker 5: challenges that we have seen. And then, now we have
• 16:12
  Speaker 5: the external third-party carrier challenges of delivering to an incorrect
• 16:18
  Speaker 5: address or.
• 16:19
  Speaker 2: Delay or lost packages, right?
• 16:20
  Speaker 5: We all know how all of these things happen to
• 16:24
  Speaker 5: our usual Amazon deliveries, for example. Now, that becomes more
• 16:30
  Speaker 5: important when you're talking about sometimes a life-saving medication.
• 16:34
  Speaker 2: For your patients. When it was lost, it was delivered
• 16:37
  Speaker 2: to the.
• 16:38
  Speaker 5: Neighbor down the street or something that you can't track
• 16:42
  Speaker 5: is something that we've seen challenges are. Our recommendation is,
• 16:47
  Speaker 5: I'm telling you that we're drafting a newsletter article that
• 16:51
  Speaker 5: kind of focus on some of the strategies. Some of
• 16:54
  Speaker 5: our recommendations include making sure that You confirm the shipping.
• 17:00
  Speaker 2: Simple thing that, you know, we want to.
• 17:03
  Speaker 5: Make sure that we call it out loud, confirm the
• 17:05
  Speaker 5: address with the patient, and also make sure that while
• 17:08
  Speaker 5: you're still engaged with the patient, that's one of the
• 17:10
  Speaker 5: first few things that you do, right?
• 17:13
  Speaker 2: You make sure that you have... The right.
• 17:16
  Speaker 5: Patient address, deleting out all the outdated addresses, reducing interruptions
• 17:23
  Speaker 5: during this whole order setup is always a good thing
• 17:26
  Speaker 5: to do. And making sure that there's some kind of
• 17:29
  Speaker 5: independent comparison between the prescription label and shipping label before
• 17:35
  Speaker 5: things are shipped out is important. More importantly, sometimes is
• 17:40
  Speaker 5: overlooked is having an adequate workspace. Some state board of
• 17:44
  Speaker 5: pharmacies have mandated certain square footage of counter space you
• 17:49
  Speaker 5: need for dispensing drugs, but people have not really think
• 17:53
  Speaker 5: about the counter space, for example, for shipping.
• 17:58
  Speaker 2: When there is clutter around.
• 17:59
  Speaker 5: You can see how easily it can contribute to swapping
• 18:02
  Speaker 5: of shipping labels and all those kinds of things. So ideally,
• 18:06
  Speaker 5: what we believe is a pharmacy system can be integrated
• 18:10
  Speaker 5: with the shipping label system, because in a lot of
• 18:14
  Speaker 5: places now they're separate.
• 18:17
  Speaker 2: If those two.
• 18:18
  Speaker 5: Systems can integrate and we can use technologies such as
• 18:22
  Speaker 5: barcode scanning to drive the population of a delivery address
• 18:28
  Speaker 5: and also be real-time tracking of your package to make
• 18:33
  Speaker 5: sure the patient is receiving it, that will be the ultimate, right?
• 18:37
  Speaker 2: And so I'm imagining a world.
• 18:40
  Speaker 5: Where almost all of the specialty medications should have a
• 18:46
  Speaker 5: very strong co-chain control and monitoring of those products that
• 18:51
  Speaker 5: require co-chain control and also an RFID technology that we
• 18:57
  Speaker 5: can easily track.
• 18:59
  Speaker 2: Where the item is.
• 19:01
  Speaker 5: Now, I have to tell you, as I was preparing
• 19:05
  Speaker 5: for this podcast, I was talking to Jennifer Young, one
• 19:09
  Speaker 5: of our specialists, about shipping in general, like all the
• 19:13
  Speaker 5: challenges between the article we're writing and the fact that
• 19:17
  Speaker 5: we are talking about this here in this podcast. One
• 19:20
  Speaker 5: thing came up is that I get, every so often,
• 19:24
  Speaker 5: I get shipments of fish.
• 19:27
  Speaker 2: Fish, not medications, from Alaska. And it's amazing.
• 19:32
  Speaker 5: One day I literally was looking at my package and
• 19:35
  Speaker 5: I was sitting there going like, wow, this is what
• 19:39
  Speaker 5: we do.
• 19:39
  Speaker 2: Now, let me tell you what they do.
• 19:41
  Speaker 5: They make sure that there is enough dry ice in
• 19:43
  Speaker 5: the package and a lot of padding to make sure
• 19:46
  Speaker 5: that the fish is always stays frozen and comes to
• 19:50
  Speaker 5: find out my nerdy husband noticed that the shipping label
• 19:56
  Speaker 5: actually has embedded an RFID in there. Well, he's just
• 20:00
  Speaker 5: nerdy because he wants to make sure that it is
• 20:02
  Speaker 5: being disposed of properly and everything. But that really gets
• 20:06
  Speaker 5: me to think about a specialty medication. Now, I have
• 20:08
  Speaker 5: to tell you, my box of fish is not that expensive.
• 20:11
  Speaker 5: Definitely not in comparison to some of these specialty drugs
• 20:15
  Speaker 5: that are thousands of dollars. They're like a hundred dollars, right?
• 20:19
  Speaker 5: And if they can do all these things to make
• 20:22
  Speaker 5: sure that that my fish comes to me frozen in
• 20:27
  Speaker 5: the right condition and tracked.
• 20:30
  Speaker 2: We should be able to do something similar with our
• 20:33
  Speaker 2: specialty medications, right?
• 20:35
  Speaker 5: So this is how passionate we are about specialty medications
• 20:40
  Speaker 5: and the whole milling and delivery side. And to this end,
• 20:44
  Speaker 5: we're actually considering adding a best practice to our targeted
• 20:48
  Speaker 5: medication safety best practices for community pharmacy. And the great
• 20:54
  Speaker 5: news is we are also incorporating specialty pharmacy in these.
• 20:59
  Speaker 2: Targeted medication safety best practices.
• 21:01
  Speaker 5: So we are changing the name of this best practices
• 21:04
  Speaker 5: to be the targeted medication safety best practices for community
• 21:09
  Speaker 5: and specialty pharmacies. And we are looking to publish an update,
• 21:14
  Speaker 5: an updated best practice at the end of this year.
• 21:19
  Speaker 2: Well, that's awesome.
• 21:20
  Speaker 1: We do have, you know, we have a big growing
• 21:22
  Speaker 1: subset of our membership that focuses on the cold chain
• 21:25
  Speaker 1: management and logistics coordination and protective packaging, right? Making sure,
• 21:30
  Speaker 1: and they partner with specialty pharmacies to make sure that
• 21:32
  Speaker 1: somebody is tracking that drug shipment, right? And it's going
• 21:35
  Speaker 1: where it's supposed to be going and it doesn't become
• 21:37
  Speaker 1: distressed and it's, you know, maintains the temperature that it's
• 21:40
  Speaker 1: supposed to throughout the entire period of transit.
• 21:43
  Speaker 2: So you're right. I mean, it is a huge area
• 21:46
  Speaker 2: of concern.
• 21:48
  Speaker 1: Yeah. So what does ISMP help specialty pharmacy move from
• 21:53
  Speaker 1: identifying risks to actually improving safety?
• 21:58
  Speaker 2: Well, we do a lot of things.
• 22:00
  Speaker 5: As I say, we focus on practical and action-oriented practices.
• 22:05
  Speaker 5: resources and plans to make sure that a lot of
• 22:10
  Speaker 5: our recommendations are actionable and practical. And so we do
• 22:15
  Speaker 5: have a specialty pharmacy membership. Medication's proper name is Medication
• 22:20
  Speaker 5: Safety Specialty Pharmacy Membership, where we provide quite a few
• 22:25
  Speaker 5: different resources. First and foremost, we provide drug-specific proactive risk assessments.
• 22:32
  Speaker 5: And With that assessment, right now we have over 350
• 22:37
  Speaker 5: drugs and biosimilars that is in our library of specialty
• 22:43
  Speaker 5: drug proactive risk assessment.
• 22:45
  Speaker 2: The goal is really to help our members.
• 22:48
  Speaker 5: Be safe and also meet and support their accreditation needs.
• 22:54
  Speaker 2: Readiness.
• 22:55
  Speaker 5: So these assessments, and we know that folks all are
• 22:59
  Speaker 5: doing their own self-assessment a lot of times as new
• 23:03
  Speaker 5: drugs come out. And the great thing is we work
• 23:06
  Speaker 5: proactively to look at what is being approved by the
• 23:10
  Speaker 5: FDA and worked on these self-assessment so that Instead of
• 23:16
  Speaker 5: every single specialty pharmacy is going, working, looking at the assessment,
• 23:21
  Speaker 5: you can use our templated assessment that we have already
• 23:24
  Speaker 5: looked from the safety lens.
• 23:26
  Speaker 2: What are some of the issues that folks need.
• 23:28
  Speaker 5: To put their thoughts in and then use that template
• 23:31
  Speaker 5: to create the action plan?
• 23:33
  Speaker 2: In their individual specialty pharmacies.
• 23:36
  Speaker 5: And so these are on our website, easily downloaded, and
• 23:41
  Speaker 5: it has standardized risk assessment questions that folks need to
• 23:44
  Speaker 5: think through as they think through every single one of
• 23:47
  Speaker 5: the drugs.
• 23:47
  Speaker 2: So that is a huge resource.
• 23:49
  Speaker 5: It takes a lot of time on our end, but
• 23:52
  Speaker 5: what we hope is that it will eventually take less
• 23:55
  Speaker 5: time collectively in the specialty pharmacy community.
• 23:59
  Speaker 2: Because we do it once and we can share it
• 24:02
  Speaker 2: with everyone. The other resource we have is.
• 24:05
  Speaker 5: The medication safety self-assessment for specialty pharmacy. And this is
• 24:09
  Speaker 5: specific for pharmacies. And this is where we have this
• 24:13
  Speaker 5: interactive self-assessment online.
• 24:16
  Speaker 2: That folks can take online.
• 24:18
  Speaker 5: And the great thing about the assessment is we don't
• 24:21
  Speaker 5: just ask one person to fill out the form.
• 24:23
  Speaker 2: And answer the questions.
• 24:25
  Speaker 5: We have different, we wanted to have specialty pharmacies With
• 24:31
  Speaker 5: staff that is a different role, like your administrator can
• 24:36
  Speaker 5: fill out the assessment and answer the questions. Your pharmacist,
• 24:40
  Speaker 5: the frontline pharmacist can fill this out. And your technicians,
• 24:44
  Speaker 5: for example, your pharmacy technician can fill this out. And
• 24:47
  Speaker 5: here we kind of compile the results of that and
• 24:51
  Speaker 5: really gives organizations a good view of where they stand.
• 24:56
  Speaker 5: And also, if there's any discrepancies between different roles of people,
• 25:01
  Speaker 5: you can then identify those discrepancies and understand why there's
• 25:05
  Speaker 5: this discrepancy. Because I can tell you as a pharmacy
• 25:09
  Speaker 5: director in my previous life, there are times when I
• 25:12
  Speaker 5: think something is is the practice because that's the policy
• 25:15
  Speaker 5: we put out, but then the actual practice could.
• 25:18
  Speaker 2: Be very different.
• 25:18
  Speaker 5: So the self-assessment can really uncover some of those disconnect
• 25:23
  Speaker 5: and help folks can fix the systems issue. Now, so
• 25:26
  Speaker 5: these are all self-assessment that, oh, and by the way,
• 25:31
  Speaker 5: this pharmacy assessment also can help members visualize, de-identify aggregated
• 25:38
  Speaker 5: data from other member pharmacies. So you can kind of
• 25:41
  Speaker 5: see if there's an area that you feel like you're
• 25:44
  Speaker 5: not doing as well, you can kind of see, oh,
• 25:47
  Speaker 5: the rest of the specialty pharmacy community also struggle with that.
• 25:51
  Speaker 2: Oh, is there some area that it's different?
• 25:55
  Speaker 5: In your prospective organization that you can reach out and
• 25:58
  Speaker 5: ask for help from other organizations. Obviously, those information is de-identified.
• 26:03
  Speaker 5: You don't know where they're coming from, but people can
• 26:06
  Speaker 5: reach out to their colleagues. And really the goal of
• 26:08
  Speaker 5: this pharmacy self-assessment is to help folks develop a safety
• 26:14
  Speaker 5: forward strategic plan.
• 26:16
  Speaker 2: And a lot of.
• 26:16
  Speaker 5: Times this could be a few years plan on how
• 26:19
  Speaker 5: you can reach some of these goals.
• 26:22
  Speaker 2: And then, of course, we help you identify your risks.
• 26:25
  Speaker 5: We also want to make sure that we help you
• 26:28
  Speaker 5: close the safety gap.
• 26:30
  Speaker 2: So, like I say, we.
• 26:31
  Speaker 5: Have best practices that will be coming out to help
• 26:34
  Speaker 5: with closing the gaps.
• 26:36
  Speaker 2: We have educational programs.
• 26:38
  Speaker 5: And, of course, we have our medication safety newsletter that
• 26:43
  Speaker 5: comes out from all the work that we do in
• 26:45
  Speaker 5: analyzing patients. errors that are coming in that we distribute
• 26:49
  Speaker 5: to all of our members. And on a quarterly basis,
• 26:53
  Speaker 5: we aggregate a lot of the issues that we see
• 26:55
  Speaker 5: in those previous newsletter and came up with an action
• 27:00
  Speaker 5: agenda where folks can look at an aggregated list of
• 27:04
  Speaker 5: potential risks that they can evaluate the specialty pharmacy against
• 27:08
  Speaker 5: and decide on what action plans they have to put
• 27:12
  Speaker 5: in place for their own specific specialty pharmacies.
• 27:18
  Speaker 1: So if listeners remember only one thing from today's conversation,
• 27:21
  Speaker 1: what would you want them to take away about medication
• 27:24
  Speaker 1: safety in specialty pharmacy?
• 27:27
  Speaker 5: I think the one most important thing they need to
• 27:29
  Speaker 5: know is that most medication errors stem from system weaknesses
• 27:35
  Speaker 5: and not individual failures. So the greatest opportunity for improvement
• 27:41
  Speaker 5: really comes from identifying and strengthening those systems and And
• 27:46
  Speaker 5: ISMP is committed to support and partner with the specialty
• 27:50
  Speaker 5: pharmacy community to advance medication safety across the community.
• 27:59
  Speaker 1: Well, thank you, Rita, for chatting with me today and
• 28:01
  Speaker 1: for sharing such valuable information.
• 28:04
  Speaker 2: Thank you. It's my pleasure.
• 28:07
  Speaker 1: As a reminder, NASP corporate members are invited to be
• 28:09
  Speaker 1: my guest on one complimentary podcast per year. For more
• 28:13
  Speaker 1: information about this or other NASP membership benefits and events,
• 28:16
  Speaker 1: please feel free to reach out to membership at naspnet.org
• 28:22
  Speaker 1: or visit our website at www.naspnet.org.
• 28:28
  Speaker 2: Until next time, have a great day.