ASHP InterSections ASHP InterSections

April 30, 2020

ASHP Continues to Support Members and the Healthcare Community Through the COVID-19 Pandemic

Filed under: Ambulatory Care,Clinical,From the CEO,Innovation,Managers,Provider Status,Quality,Regulation,Residents,Specialties,Students — Tags: , , , , , , , , , , , , , , , , , , — jmilford @ 11:04 pm

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE COVID-19 PANDEMIC is changing our country’s healthcare landscape every day. Critical health policy changes are occurring at an unprecedented rate. We continue to engage with state and federal policymakers to ensure that pharmacists’ expertise is fully utilized and that healthcare providers are equipped to safely and effectively respond to the pandemic.

Update on States’ Response Efforts

State governors are issuing executive orders that expand pharmacists’ ability to provide high-quality care to patients during this crisis. For example, Michigan now permits pharmacists within licensed health facilities to contribute to routine health maintenance and manage chronic disease states without physician supervision. This expansion alleviates burdens on primary care providers and expands access to care, especially in rural and underserved communities where pharmacists are the most accessible healthcare professionals.

We are also seeing a positive trend in pharmacists’ ability to manage therapeutic interchange. In Iowa and Kentucky, executive orders grant pharmacists the authority to substitute medications in response to drug shortages.

Point-of-care testing for COVID-19 is critical to the national pandemic response. Some states already permitted pharmacists, under their scope of practice or through collaborative practice agreements, to order and administer these tests. Pennsylvania, which previously allowed pharmacists to order and administer tests, has taken emergency measures to grant pharmacists explicit authority to order and administer COVID-19 tests. States like Florida, Illinois, Kentucky, and, most recently New York, issued executive orders that permit pharmacists to order and administer COVID-19 tests. State-level COVID-19 response is a rapidly changing situation as local healthcare providers respond to patient surges and the demand for testing. Please check with your state’s board of pharmacy for more information about the status of COVID-19 testing in your area. Helpful information on COVID-19 testing can also be found on the National Community Pharmacists Association’s website.

ASHP applauds state governors’ efforts to expand pharmacists’ scope of practice during this state of emergency. However, we are concerned that authorizing the expansion of pharmacists’ services without authorizing payment for those services will limit the delivery of care in some pharmacy practice settings. COVID-19 is already highlighting shortcomings in state Medicaid payment systems and commercial payer policies that prevent qualified pharmacists from fully serving patients. ASHP is working closely with our state affiliates and other organizations to request reimbursement for the new services they are providing under the state of emergency. This advocacy aligns with ASHP’s Pharmacy Readiness for Coronavirus Disease 2019 (COVID-19) Recommendations for State Policymakers. The recommendations address shortages of drugs and medical supplies and reimbursement of pharmacists for patient care services and also provide readiness and resilience resources for clinicians.

Pharmacists are Essential Healthcare Personnel

ASHP continues to voice our support for all pharmacists who are working tirelessly across the continuum of care in response to the COVID-19 pandemic. Yesterday, I sent a letter to the chief executive officer of Novo Nordisk responding to a full-page NovoCare ad that ran last weekend in the Wall Street Journal and other publications. Pharmacists were omitted from a list of individuals, including nurses, doctors, researchers, and other essential workers who were acknowledged for their caring efforts on the front lines of the COVID-19 response.

In the letter, I reinforced that pharmacists are highly skilled, licensed healthcare professionals who play a key role in selecting and optimizing medication therapy for patients. Pharmacists also oversee the entire medication-use process in hospitals and health systems, including the purchasing, distribution, preparation, and administration of pharmaceuticals. I further explained that, as members of interprofessional healthcare teams, pharmacists are providing a broad range of patient care services during the COVID-19 public health emergency, from directly caring for mechanically ventilated patients in critical care settings, to providing point-of-care testing and medication management to patients in community pharmacy settings and beyond.

It is my hope that Novo Nordisk will appropriately recognize pharmacists and the important role they play in future communications.

ASHP’s Response to Disruptions in Residency Training

In last week’s blog, I discussed the COVID-19 pandemic’s impact on residency training. As a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays, some hospitals and health systems are facing the difficult situation of furloughing their PGY1 and PGY2 pharmacy residents. These actions can disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. We believe that educating future generations of pharmacists is more critical than ever, and ASHP has issued a statement opposing the furlough of residents.

As always, ASHP is here to support residents and residency programs. If you need assistance with a furlough situation, please reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services.

ASHP is Here for You and the Entire Healthcare Community

Over the past several weeks, I have been sharing information about new and timely resources that ASHP has developed and made available to optimize medication use and patient outcomes during this public health emergency. The response to these offerings, which is captured in a new ASHP infographic, has been tremendous. We are immensely proud of our staff and volunteers who have been working tirelessly to deliver highly relevant information across multiple channels. Our COVID-19 Resource Center is updated regularly with new content and I hope you continue to find the tools and information produced by ASHP valuable as needs related to the pandemic response evolve.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 16, 2020

New ASHP Resources and Efforts to Help You Combat COVID-19

Filed under: Ambulatory Care,Clinical,From the CEO,Innovation,Managers,Residents,Specialties,Students — Tags: , , , , , , , , , , , , , , , , , , , , — jmilford @ 7:49 pm

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

ASHP CONTINUES TO WORK ACROSS MULTIPLE FRONTS to help our members and all healthcare professionals to address the COVID-19 pandemic. We have intensified our advocacy efforts and continue to create new and timely resources to ensure that you are prepared to meet the demands of this sustained public health crisis.

Based on concerns expressed by ASHP members who are on the front lines of the COVID-19 pandemic, I’ve had calls with a wide array of industry stakeholders, including wholesalers, about ways to help ensure that providers have the medications they need to treat their patients. Please continue to let us know of challenges you may be facing related to COVID-19, and we will work to do everything we can to help address them at the national level.

To that end, today, we launched a new COVID-19 microsite to better organize our resources and optimize access for those who need them. The microsite features content for pharmacists and other healthcare providers in key areas, including patient care, infection prevention, policy and advocacy, and more. We will continue to enhance the site with new and updated content, which remains open to all professionals who are engaged in the COVID-19 response.

A critical focus of our continued support remains facilitating real-time information sharing among pharmacists, including those in the current epicenters, to help ongoing response efforts and prepare areas where the peak of the pandemic is yet to come.

In response to the COVID-19 pandemic, we have accelerated production on our popular @ASHPOfficial podcast, moving to a daily release schedule. We have produced 20 episodes to date dedicated to COVID-19 on topics that include managing drug shortages, evaluating the scientific literature, and ethical considerations. Last week, a member let us know that information from an @ASHPOfficial podcast helped her to change treatment protocols for patients at her long-term care facility, potentially saving many lives. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content that includes credible information, best practices, and important experiences from your peers who are working on the front lines of the pandemic.

We have also recently launched a free webinar series dedicated to COVID-19 response. Tomorrow’s live webinar describes how New York’s Mount Sinai Health System and Montefiore Health System responded to their COVID-19 patient surge, and the coordinated efforts of New York City’s pharmacy leadership to support hospitals and health systems. Please be on the lookout for new webinars each week that will provide valuable perspective and intelligence on how pharmacists in varied settings are responding to the pandemic.

Our COVID-19 Connect Community has become a robust venue for discussion and information sharing among pharmacists. There are more than 52,000 community members actively engaged in 800 different discussion threads covering a range of topics. ASHP is also using this platform to help inform our efforts to develop and deliver crucial resources to assist those on the front lines.

I would also like to make you aware of another new initiative launched this week by ASHP. The Pharmacy Executive Leadership AllianceTM – or PELATM – was created for chief pharmacy officers and multi-hospital system pharmacy executive leaders who face distinct challenges working within highly complex, vertically and horizontally integrated networks and multi-hospital health systems.

PELA will leverage ASHP’s resources for information exchange on issues unique to this executive-level group. PELA participants will gain valuable insights on market trends and innovations for advancing medication use that is always optimal, safe, and effective for all people across our nation’s complex health networks. Key areas of focus will include health-system-wide integration of digital and telehealth, effective enterprise revenue cycle management, strategies for addressing industry disrupters, optimization of horizontal and vertical integration, and new technologies and science. Emerging issues related to COVID-19 business recovery will also be addressed.

Although ASHP has been planning the launch of PELA for some time, the unprecedented demands of the COVID-19 pandemic underscore the importance of providing opportunities to connect and share critical information for pharmacy executives. I look forward to sharing more information about this exciting initiative, as well as relevant outputs from the group, with our members in the future.

Finally, I wanted to share some news from the advocacy front. This week, the Drug Enforcement Administration (DEA) announced flexibilities for satellite hospitals or clinics as a result of COVID-19. During the national emergency, DEA will allow a DEA-registered hospital or clinic to handle controlled substances at a satellite hospital or clinic location under the organization’s current registrations. DEA is relaxing limits on the distribution of controlled substances between practitioners. Under the new flexibility, registered practitioners can distribute or dispense more than 5% of their total doses to another registered practitioner without registering as a distributor. Practically speaking, this will better enable health systems and hospitals to get controlled substances where they are most needed. DEA is also allowing distributors to ship controlled substances directly to these satellite hospitals or clinics. This is a significant change for many of our members who use additional satellite hospital and clinic locations to accommodate the large influx of COVID-19 patients presenting for treatment. Having these flexibilities will allow our members to more effectively treat their patients.

I am also pleased to note that, at the urging of ASHP and its members, USP has issued “Operational Considerations for Sterile Compounding During COVID-19 Pandemic,” a new document that supports risk-based enforcement discretion of compounding standards. The document addresses the assignment of beyond-use dates and considerations for certification and recertification of engineering controls, and reinforces CDC recommendations for cleaning and disinfecting a facility when someone is ill.

On Tuesday, ASHP, the American Pharmacists Association, and the National Community Pharmacists Association authored a letter to New York Sen. Chuck Schumer thanking him for recognizing pharmacists as providers of essential patient care services and asking him to support pharmacists’ critical role as frontline healthcare providers during the COVID-19 pandemic. ASHP will continue to work with Sen. Schumer and others to recognize the vital patient care role of pharmacists and to support the proposed Heroes Fund legislation that provides premium pay for essential front line workers – including pharmacists – during this current public health crisis, and we will continue our broader efforts to advocate for expanded patient access to pharmacist services.

In closing, please know that we remain committed to supporting you by providing robust, timely, and relevant resources to assist you in your practice, to advocate on your behalf, and to help you focus on your own health and well-being during this ongoing public health emergency.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

April 9, 2020

Important Wins on the Advocacy Front in the Fight Against COVID-19

Filed under: Ambulatory Care,Clinical,From the CEO,Innovation,Managers,Provider Status,Quality,Regulation,Residents,Specialties,Students — Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , — jmilford @ 4:36 pm

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

AS THE IMPACT OF THE COVID-19 PANDEMIC CONTINUES TO ESCALATE ACROSS THE COUNTRY, there is increased urgency to ensure that frontline pharmacists, pharmacy technicians, and our healthcare partners have the medications and equipment they need to successfully treat their patients. ASHP continues to spearhead multiple advocacy efforts that support your ability to provide the best care possible for those in need.

Mitigating shortages of critical medications like propofol, fentanyl, midazolam, paralytics, and others remains a high priority. We continue to engage with relevant federal agencies to improve access to medications. I am pleased to report that the Drug Enforcement Administration (DEA) and the Food and Drug Administration (FDA) have taken critical actions in direct response to ASHP’s advocacy efforts.

ASHP, in coordination with the American Medical Association, the American Hospital Association, the Association for Clinical Oncology, and the American Society of Anesthesiologists, sent a letter last week to the DEA requesting an immediate increase in the annual production quota allocations for Schedule II controlled substances. This would enable manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to the care of COVID-19 patients on ventilators. As a direct result of this collaborative advocacy effort, the DEA announced yesterday that it is taking immediate actions to address this critical issue. These actions include increasing the annual production quota for controlled substances, including fentanyl, morphine, and hydromorphone, that are used for the treatment of mechanically ventilated COVID-19 patients, and increasing the amount of ketamine, diazepam, and other controlled substances that can be imported into the United States.

We also sent a letter to the FDA advocating for regulatory flexibility in compounding drugs in shortage and compounding in hospitals. ASHP’s advocacy efforts, including significant staff engagement on the issue, directly triggered the FDA to clarify existing compounding guidance, including the removal of the one-mile radius requirement for hospitals compounding medications. FDA’s quick action to reduce regulatory hurdles for health systems is an important step to help clarify compounding guidance during this crisis.

ASHP will continue to advocate for additional compounding flexibility, including the expansion of FDA’s drug shortage list to include products ASHP has identified as in shortage. We will also continue to seek 503B outsourcing facility flexibility, particularly for hospital-owned or affiliated 503B operations, to help ensure they can meet hospitals’ medication needs.

Yesterday, we were pleased to see that the Department of Health and Human Services (HHS) authorized pharmacists to order and administer COVID-19 tests pursuant to the Public Readiness and Emergency Preparedness (PREP) Act. The authorization is responsive to the joint COVID-19 recommendations we created with other national organizations. While this authorization does not address pharmacist reimbursement, we are encouraged to see HHS providing pharmacists with a greater role in supporting the COVID-19 response, and we continue to work on that issue.

We also continue to actively advocate for Congress to recognize pharmacists as providers in the Medicare program to further support the COVID-19 response and beyond. Yesterday, ASHP and 11 other national organizations sent a letter requesting that Congress immediately support legislation that would establish pharmacists as providers in Medicare Part B on an emergency basis to provide COVID-19 and flu testing. This authority is an important step in being able to rapidly expand access to testing across our country to support the national response to this crisis. We also see this as a step toward expanded recognition of pharmacists by payers, including Medicare.

Finally, ASHP is also working with our members and other stakeholders to gain access to medications from the Strategic National Stockpile (SNS). Most recently, we joined with several organizations to request that FEMA immediately release all available quantities of a number of critical drugs from the SNS to the New York and New Jersey Departments of Health to address urgent patient care needs. We are also working to support other state affiliates and members across the country with these important requests.

ASHP and its government relations team will continue to work tirelessly with our collaborating partners to ensure that U.S. regulatory authorities are responding to the current needs of pharmacists and healthcare providers.

While our collective attention is on the needs of frontline practitioners, I wanted to take an opportunity to highlight some positive news about the newest members of our profession. ASHP’s 2020 Residency Match concluded this week, and I want to congratulate the 5,269 future pharmacists who matched with 2,551 PGY1 and PGY2 pharmacy residency programs across the country. This number represents a 46% increase in the number of available positions over the past five years – a remarkable rate of growth. I am pleased that our accredited residency programs have demonstrated an outstanding commitment to training during the pandemic. While managing multiple critical priorities, these programs continued to interview applicants virtually. This undoubtedly will be a unique time during which to begin a residency program regardless of its focus. ASHP is committed to ensuring that these young practitioners and their programs have the needed resources to successfully conduct critically important resident training this year and beyond.

In the same vein, please know that ASHP stands ready to offer you and your healthcare colleagues that same level of steadfast support. In addition to advocating to give you access to critical medications, ASHP continues to update and create new resources and tools that can be found on our COVID-19 Resource Center. We have also opened access to many evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community.

Over the last few weeks, I have heard countless stories from members and others about the challenges they are facing, but I’ve also heard many stories of hope and heroism. I, and David Chen, ASHP assistant vice president for Pharmacy Leadership and Planning, have listened in on calls from pharmacy leaders at major health systems in New York City, the pandemic’s current epicenter. We are incredibly impressed by how these leaders have shared their information and experiences and how they support each other and their frontline staff. This is a tremendous example of how peer-to-peer connection and communication can aid in the pandemic response. Their experiences and willingness to share their stories will undoubtedly help others in responding to COVID-19 in facilities across the country. We applaud them for these efforts.

Please also know that ASHP is here to support your well-being, which should remain a priority for all healthcare personnel during this challenging time. Please make sure that you are taking care of yourself and your family.

“ASHP has our backs.” These are the words of a member who recently reached out to us. This really resonated with me, and I can assure you that we will continue to work across all fronts, leveraging our talented staff, our valued partners, and our amazing members to provide you with the information, connections, and resources you need today and in the future.

Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

February 21, 2020

New Mexico Legislation Expands Access to Pharmacist Care

Filed under: From the CEO,Managers,Provider Status,Regulation — Tags: , , , , , , , — jmilford @ 7:57 pm

Dear Colleagues,

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

A concerted and highly organized effort has resulted in a significant step forward for pharmacists and patients in New Mexico. Pharmaceutical Services Reimbursement Parity (House Bill 42), passed by the New Mexico Senate on February 20, will expand access to healthcare by enabling pharmacist clinicians and other pharmacists with prescriptive authority to be reimbursed for clinical services.

ASHP’s Government Relations team worked closely with the New Mexico Society of Health-System Pharmacists (NMSHP), the New Mexico Pharmacy Association, the UNM College of Pharmacy SSHP, and others to mobilize grassroots support urging Gov. Michelle Lujan Grisham and members of the New Mexico legislature to pass the bill.

This is a wonderful achievement for pharmacists and their patients in New Mexico. It also serves as a strong building block as we work toward achieving pharmacy provider status nationally. Supporting states in expanding access to pharmacist care is a key part of ASHP’s larger vision that medication use will be optimal, safe, and effective for all people all of the time.

Multiple studies have shown that pharmacist-provided clinical services expand access to care, improve chronic disease outcomes, and help decrease the cost of care with research estimating that every $1 invested in clinical services by pharmacists reduces overall healthcare costs by $4.[1] We are working hard to make sure that policymakers across the country recognize that value and the impact you bring to patient care.

I would like to express my thanks to all of the individuals and organizations that worked so hard to support the passage of the bill, including Keenan Ryan, NMSHP president, Dale Tinker, executive director of the New Mexico Pharmacists Association, and the students at UNM College of Pharmacy who worked to make sure every legislator in New Mexico understood the importance of this legislation.

We have great momentum on this critical issue and look forward to continuing our advocacy efforts on expanding access to pharmacist care in other states to help improve patient health for all.

Thank you for being a member of ASHP and for everything that you do for your patients and our profession.

Sincerely,

Paul

 

[1] Avalere. Exploring Pharmacists’ Role in a Changing Healthcare Environment. May 21, 2014, available at https://avalere.com/insights/exploring-pharmacists-role-in-a-changing-healthcare-environment

 

 

 

November 5, 2019

Namaste: ASHP Members are Pharmacists and Certified Yoga Instructors

Filed under: Ambulatory Care,Clinical,Feature Stories,Innovation,Managers,Residents,Specialties,Students — Tags: , , , , , — jmilford @ 2:01 pm

Seena Haines, Pharm.D., FASHP, BCACP

SEENA HAINES, Pharm.D., FASHP, BCACP, has long embraced physical fitness. Throughout her career, the professor and chair of the Department of Pharmacy Practice at the University of Mississippi School of Pharmacy has lifted weights, taken kickboxing and spin classes, and attended boot camps. Even when she exercised twice a day, she sometimes felt overwhelmed and in need of something to help reduce stress.

About three years ago, a pharmacy colleague suggested she try yoga. Dr. Haines took advantage of an introductory special offered by a local yoga studio. Within a few sessions, she was hooked, going to class several times a week. She has since become an instructor who teaches yoga to residents and college students at the studio where she trained. She also teaches yoga at national conferences.

“I was completely amazed by the impact it had on my mindset and my stress levels,” she said. “It helped quiet what I call the ‘monkey mind’ and focus on the present moment. This was exactly the mind-body connection and stillness that I was searching for that I couldn’t find through other group conditioning activities.”

Yoga provides calm and balance
Dr. Haines is one of several ASHP members who have not only embraced yoga but have gone on to become certified yoga instructors. Kathryn Samai, Pharm.D., BCPS, is an emergency medicine clinical pharmacist at Sarasota Memorial Healthcare System in Florida. She is an instructor and enthusiast of Ashtanga yoga, a vigorous physical form of yoga that combines synchronizing breath with various postures.

She said the practice has helped her better interact with her colleagues. Yoga reminds her that everyone has stress and difficulties. She approaches each person with more compassion and a sense of shared connection. “As pharmacists, we deal in this very fast-paced workflow where you have to be extremely meticulous and extremely detail-oriented,” Dr. Samai said. “We interact with a lot of people who are upset, hurting, and stressed-out, whether it’s our co-workers or our patients.”

Hala Hijazi, Pharm.D.

She has discovered that yoga gives her more time because she operates in a different mindset. “It’s almost like you can slow things down even though the workflow is never going to slow down,” she said. “Yoga is the attainment of a calm and peaceful state of being.”

ASHP member and yoga instructor, Hala Hijazi, Pharm.D., agrees. She is a clinical staff pharmacist at King Faisal Specialist Hospital in Riyadh, Saudi Arabia. Dr. Hijazi found yoga as a teenager when her aunt suggested she try it to help manage the stress surrounding her ulcerative colitis.

Dr. Hijazi noted that practicing yoga helped her survive her pharmacy residency and today makes her feel more balanced in her life, work, and spirituality. A breathing technique called pranayama, also known as the life force, helps her get into a meditation state.

“I learned to slow down, be more patient, and focus more,” Dr. Hijazi said. “Now, when I have a few tasks to do, I don’t become stressed-out about them. I prioritize and take it task by task.”

Benefits of yoga
Published studies demonstrate many benefits to yoga, Dr. Haines noted, including lowered anxiety, depression, and risk for cardiovascular events. “I feel that practicing yoga is essential for success in preventing disease onset and severity,” she said. “It can provide dividends now and in the future as we continue to age.”

Yoga not only is good for flexibility and physical health but also can help people become more centered, added Dr. Samai. “When you start to do these physical postures, you lengthen your spine and [improve your] ability to bend and move. You find yourself becoming more patient, more compassionate, making a little more room for kindness,” she said.

Yoga for beginners
There are many ways for busy pharmacists and student pharmacists to incorporate yoga into their lives, said the interviewees. Ideally, try a class at a local studio or even online, Dr. Hijazi advised. Initially, she said, “just an hour a week was enough for me to feel like I was going to be ok.”

Kathryn Samai, Pharm.D., BCPS

Some hospitals or institutions host classes. In addition to her studio classes, Dr. Samai teaches 15-minute sessions of gentle yoga at her hospital a couple of times a month. These short sessions are focused on relieving stress and fatigue.

Dr. Samai advises individuals who are new to yoga to try different types. Some may seem too physical or too gentle, or have too much chanting for your taste, she said.

According to Dr. Haines, there are many styles of teaching, and it may take some time to find what works for you. Be patient with yourself as your body adjusts to some of the positions. Over time, you will see improvement, she added.

Dr. Hijazi explained that yoga doesn’t have to take up a lot of time. Take five minutes when you wake up, after work, or before you go to sleep, to turn your attention inward. Do some breathing techniques to slow down, or think of things for which you are grateful, noted Dr. Hijazi, who teaches classes at her home, a local studio, and online.

Dr. Samai sets alarms on her phone to remind her to repeat one of her mantras. Pharmacists can do something similar each time they do an automatic task, like washing hands or using sanitizer before entering a patient room. When a pediatric patient died in the ED recently, she took a few minutes for breathing as a transition before resuming work. “You don’t have to get yoga pants, you don’t need to drive somewhere or do something,” said Dr. Samai. “Those little moments of mindfulness are yoga.”

Remember that yoga is a life journey, not just a session where you go and work out, said Dr. Hijazi. “I would say to any pharmacist or health care practitioner, we should give ourselves time every week to find ourselves, and yoga helps us do that,” she added.

 

By Karen Blum

 

# # #

September 17, 2019

Young Pharmacists Show that Helping Others is a Prescription for Well-Being

Filed under: Ambulatory Care,Clinical,Feature Stories,Innovation,Managers,Residents,Specialties,Students — Tags: , , , , , , , , — jmilford @ 1:57 pm

Emily Belarski, Pharm.D., goes hiking to decompress after a stressful day.

BURNOUT IS BECOMING INCREASINGLY COMMON among early career pharmacists. A study published in AJHP found that pharmacy residents working more than 60 hours per week reported high levels of stress, depression, and hostility. ASHP InterSections caught up with four former ASHP externs, who were student pharmacists during their rotation experience at ASHP HQ, to learn how they integrate well-being into their busy schedules and inspire resilience among their co-residents and colleagues.

Embrace Team Power
In the middle of a relentless month of 4:30 a.m. wake-ups, long clinic hours, and late nights reading for the next day’s topic discussions during a pediatric hematology/oncology rotation in her second year of residency training, Emily Belarski, Pharm.D., felt she had to change her approach.

“The biggest thing that led to burnout during that period was having a huge knowledge gap and finding it really, really overwhelming to fill it,” recalled Dr. Belarski, who is now a General Pediatrics Clinical Pharmacist Specialist at University of Chicago Medicine’s Comer Children’s Hospital.

She was reluctant to bring it up to her preceptor, but it turned out that her preceptor was very receptive. Dr. Belarski shared her struggle, and together, they devised a plan to strengthen her clinical skills while decreasing stress. “By choosing one topic to learn about daily, rather than floundering with a long list of topics for the topic discussions, I could build my learning skills and not become overwhelmed by my knowledge gaps,” she said.

This strategy led to an a-ha moment for Dr. Belarski. “I was there to build the skills to find the answers, not just to learn the answers. That changed my outlook on residency and made me a lot less stressed,” she said.

Learners may be intimidated to ask for help in a situation like this, but reaching out to her preceptor was something Dr. Belarski wishes she had done sooner. “Talking with my preceptor at the time left me feeling that it was okay not to know everything,” she said.

Adding her preceptor to her support network also enlarged a circle that already included family, friends and, importantly, co-residents, Dr. Belarski noted.

Promote a Culture of Listening
Meredith Oliver, Pharm.D., a PGY2 infectious diseases pharmacy resident at the University of Utah Health, considers herself an advocate for resilience and well-being among the hospital’s residents.

Meredith Oliver, Pharm.D., spends time in Utah’s Wasatch National Forest after a long day in the hospital.

“As healthcare professionals in training, we have a lot of responsibilities that pull us in many directions every day,” said Dr. Oliver. “But slowing down and listening to both our colleagues and our patients is crucial to our work and the success of patient outcomes.”

Dr. Oliver said she struggled to maintain her resiliency while working with “very sick patients” and managing complex treatment regimens during a recent hematology-oncology ICU rotation. “I was having many difficult conversations about the goals of care with patients, and these were often challenging to process,” she said. “However, working alongside amazing healthcare professionals meant that I did not feel alone in fighting for my patients.”

Dr. Oliver said the experience left her wanting to help others cope with their instances of burnout, so she trained to be a peer support volunteer through the University of Utah’s Health’s Resiliency Center. The Center helps healthcare professionals, including the pharmacy program’s 25 residents, manage clinical burnout and teaches them strategies to create wellness and resilience.

One of those strategies is to grant colleagues “the space to feel heard,” said Dr. Oliver. “I’m very grateful that I can share my successes and struggles with my co-residents.”

Although personal strategies can help ensure resilience and well-being, “it needs to be paired with an organizational culture and structure to combat clinician burnout, so that we can give ourselves fully to our patients. They are what matter the most,” said Dr. Oliver.

Student Wellness Curriculum
Imagine this: as a student pharmacist, you saunter into a classroom and casually chat with your peers about a new restaurant you want to try, or a hike you’d like to take. Then you sit down for a 10-minute guided meditation.

Autumn Pinard improves her resilience by spending time outdoors.

If this sounds like a guilty pleasure in a busy student’s life, Autumn Pinard believes you should think again. “We need to make sure we take care of ourselves so that we can take care of our patients,” said Pinard, who is entering her P2 year at the University of New Mexico College of Pharmacy.

Pinard enrolled in the new elective wellness course described above to avoid burnout. “In the past, I gave too much of myself, and I wasn’t paying attention to my well-being,” she said.

In addition to helping her improve resilience, the course inspired Pinard to help other students. She is looking into being a teaching assistant (TA) for a new iteration of the course slated for the 2020 spring semester. “I want to promote resilience and well-being in school early on, before people experience burnout,” Pinard said.

She is currently waiting for confirmation of the course and the TA position. Her vision for the new curriculum is “to dedicate lots of time to exploring meditation, learning more about ourselves and our strengths, and developing emotional intelligence.”

Access to Free Counseling
When Lubna Mazin, Pharm.D., started pharmacy school at the University of Texas at Austin College of Pharmacy, access to mental healthcare required going through a vetting process, being placed on a list, and then paying for the services.

“There were a lot of barriers that prevented students from getting counseling,” said Dr. Mazin, who is currently completing a health-system pharmacy administration residency at Nationwide Children’s Hospital, Columbus, Ohio.

Lubna Mazin, Pharm.D., climbs mountains to ward off burnout and stress.

In her P3 year, after coming out of her own period of burnout and finding ways to reduce the risk of a repeat episode – primarily by maintaining a daily exercise regimen – Dr. Mazin joined the university’s Mental Health and Wellness Committee. She advocated for easier access to mental health services. The committee’s efforts paid off, and the university’s president signed off on a new policy that provided free counseling services to students.

“The free services were especially important after several tragedies took place at the school,” recalled Dr. Mazin. Students were reluctant to discuss the difficult topics that arose during those crises, Dr. Mazin noted. The counselors turned to a tried-and-true method of bringing students together—free pizza. “That got students sitting around in one place and gave counselors an opportunity to ask them how they were feeling,” she said.

Moving forward, Dr. Mazin would like to see wait times for university mental health services, particularly for those in crises, reduced. “Getting funding for that type of mental health service, even if it’s talking to someone for 15 minutes, is the next step,” she said.

 

By David Wild

 

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