ASHP InterSections ASHP InterSections

December 18, 2009

A Pharmacy Icon Looks to the Future

Kevin J. Colgan, M.A., FASHP

ASHP WILL LOSE A VENERABLE GIANT of the profession to retirement in a few years, and I felt that it was important to acknowledge this significant transition. You may already have heard that ASHP’s esteemed EVP and CEO Henri R. Manasse, Jr., Ph.D., Sc.D., recently announced his retirement as of June 30, 2011.

This dedicated ASHP executive has worked tirelessly for more than a decade to provide big-picture thinking about the future of the profession. He is a passionate, eloquent advocate of medication safety. And he has proffered exceptional leadership to ASHP’s Board of Directors; councils, committees, and House of Delegates; and staff members along the way.

Perhaps the most important contribution Henri has made—and continues to make—to ASHP and its members is his important work in raising the visibility of the Society exponentially among other healthcare organizations, both in the U.S. and internationally. A fixture in the hospital and health-system pharmacy world, Henri is well-known in national healthcare, legislative, and regulatory circles.

From the National Patient Safety Foundation, the Institute of Medicine, and the Food & Drug Administration to The Joint Commission, Congress, and International Pharmaceutical Federation—and all points in between—Henri has had measurable impact on educating others about the value pharmacists bring to patient care and quality outcomes.

Henri continues to serve all of us well as the voice of ASHP and health-system pharmacy practice. I, for one, deeply value the friendship we’ve enjoyed over the years, and I look forward to our work together this year and into the future.

Kevin J. Colgan, M.A., FASHP

October 9, 2009

The Battle Over Quality Health Care

Henri R. Manasse, Jr., Ph.D., Sc.D.

Henri R. Manasse, Jr., Ph.D., Sc.D.

AS CONGRESS CONTINUES TO WRESTLE over the details of health care reform, ASHP is keeping its focus on what matters most to hospital and health-system pharmacists and our patients. And members have been behind us all the way. During White House forums last spring and in visits with members of Congress and their staffs during Legislative Day in September, ASHP members highlighted the many ways in which pharmacists improve patient care.

ASHP’s health care reform principles have been very helpful in our ongoing dialogue with legislators and regulators. These principles are essentially three-pronged:

• We want to ensure that patients have coverage for safe and effective medication use,

• We want sustainable financing for health care coverage to help manage costs, and

• We want incentives that align with and encourage quality health care.

These principles help to promote the pharmacist’s value by demonstrating the role of a pharmacist in safe medication use. They support best practices by allowing innovative practices to be recognized, disseminated, and provided to patients. And they focus on quality, which provides opportunities to promote prevention and develop the pharmacy work force.

Specifically, we would like to add annual medication therapy review and assessment by a pharmacist to all Medicare Part D plans and include pharmacists as nonphysician providers under Medicare Part B.

Direct advocacy is not the only way that we are trying to influence the debate in this country over improved patient care. ASHP’s 2015 Initiative continues to be a shining light for improved quality and medication safety and efficacy. We are excited to hear from the increasing number of hospitals and state affiliates that are using the Initiative’s six goals and 31 objectives to drive their own strategic planning.

There is even growing international interest in the project. The Spanish Society of Hospital Pharmacists has modeled its own 2020 Initiative after ASHP’s work. Recently, I presented to the society via video about the 2015 Initiative. You may find this basic overview of the program to be helpful.

Stay tuned as ASHP works to secure a place for hospital and health-system pharmacists in coming changes to our nation’s health care.

Henri R. Manasse, Jr., Ph.D., Sc.D.

Living in the Digital World

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Lynnae M. Mahaney, M.B.A., FASHP

WELCOME TO THE NEW DIGITAL EDITION of ASHP InterSections! I hope you are as excited as I am by the debut of a more interactive, easy-to-read magazine. As a digital publication, InterSections is now tapping into the power of the Web by offering readers relevant Web, audio, and video links embedded within the stories.

Our intention is that you find this to be a value-added experience, as you are able to search and read more about each topic than was possible with a print-only publication.

This new format also continues ASHP’s commitment to environmental and economic stewardship—no trees were harvested for this publication, and a digital format eliminates the burden of ever-increasing postage.

Since its founding in 2006, ASHP Inter-Sections has sought to bring you stories about fellow practitioners who are on the leading edge of practice and hot topics such as work-life balance, as well as information about what your society is doing for you.

This issue is no exception. Our cover story on the importance of health literacy—and the tools pharmacists can use to help patients understand their medications better—is eye-opening and something you won’t want to miss.

As the number of schools of pharmacy increases, more and more students are seeking introductory experiential education slots. If your hospital is considering implementing this type of program, check out the story on page 12. You will find information on the many benefits for institutions that are reaching out to students in this way.

How has the sputtering economy impacted your hospital or health system? On page 14, you will be able to see how fellow practitioners are dealing with reduced inpatient numbers, hiring freezes, and budgets that have come under increased scrutiny.

All of us here at ASHP look forward to your feedback and suggestions about the new ASHP InterSections. Drop me a line at or contact me on the new ASHP blog and let me know what you think.

Lynnae M. Mahaney, M.B.A., FASHP

December 1, 2008

As Fires Raged, ASHP Members Stepped in to Help

ASHP members were instrumental in helping evacuees from the vast southern California wildfires in late October to manage their medications, highlighting the crucial role pharmacists can play in emergency situations.

More than 150 pharmacists and pharmacy students worked around-the-clock shifts at the Qualcomm Stadium and other shelters in San Diego over the course of four days to provide medications for hundreds of weary nursing facility patients and other evacuees.

Reconstructing Medical Records

“There was a big need for pharmacists. All of those nursing home patients really needed their medications” said S. John Johnson, Pharm.D., a pharmacy manager at Sharp Memorial Hospital in San Diego and ASHP member who helped fill some of the more than 500 prescriptions dispensed during the evacuation.

As thick, noxious smoke hovered over the San Diego region, volunteers buckled down at the makeshift pharmacies to provide needed medications, sometimes helping patients avoid admittance to hospitals. Some patients were evacuated so quickly that medical records were left behind, and elderly patients struggled to comprehend or communicate as pharmacists tried to glean the information.

 Despite the challenges, healthcare professionals of all types were able to successfully maintain continuity of care for patients affected by the fires.

Treating Patients at the “Bar-macy”

For pharmacists and pharmacy students at the stadium, that work occurred at the affectionately labeled “bar-macy,” a temporary pharmacy set up at a bar inside the facility. There, first-year pharmacy students rubbed elbows with seasoned pharmacists who dispensed drugs from behind beer taps. What made the experience all the more harrowing for the pharmacists who volunteered was the fact that many of them also had to evacuate their own homes in the face of fire.

On Oct. 22, the day after the fires erupted, Craig Steinberg, Pharm.D., pharmacy manager at Sharp Coronado Hospital, Coronado, Cal., and chairman of the San Diego Pharmacy Emergency Response Team (RXERT ), was helping to set up the pharmacy at the Del Mar Fairgrounds shelter when the call to evacuate his Del Mar neighborhood came in.

He raced home to his family and collected music, photos, and other memorabilia, and shot a video of the entire home to help with insurance claims in case the house was consumed in the fire. The family then headed to a friend’s home away from the fire.

“We had a couple of hours, and we packed up four cars and drove away,” Steinberg said. After a brief respite, Steinberg headed back to the Del Mar shelter pharmacy.

Steinberg and Johnson helped start RXERT . When the evacuations started, Johnson sent out 1,500 e-mails to pharmacists on the team’s contact list seeking volunteers to serve at the shelters. Day after day, dozens of pharmacists, pharmacy students, and technicians answered Johnson’s call.

Pharmacists as Primary Caregivers

 “In situations like this, you become a primary caregiver. It’s up to the pharmacy community to put together a response to disasters,” Johnson said, highlighting how important it is for pharmacists to become trained in emergency response.

It is a belief that ASHP ardently shares and fully supports. That’s why the Society has established a professional policy on emergency preparedness, developed a comprehensive emergency preparedness resource center on its Web site, and helped establish national pharmacist response teams after 9/11.

Cutting-Edge Care at the VA

Having worked for the U.S. Department of Veterans Affairs (VA) for a quarter century, Jan Carmichael, Pharm.D., FCCP, BCPS, has witnessed its evolution into a technologically savvy institution.

Key among those innovations is the VA’s centralized patient information system, which pharmacists use to access patients’ entire medical histories.

“There is power in that because you can identify problems in larger groups,” said Carmichael.

 A pharmacy executive with one of the VA’s 21 Veterans Integrated Service Networks and past president of ASHP, Carmichael believes there are many benefits of working with the nation’s largest healthcare system. For instance, VA pharmacists can evaluate and prescribe medications on collaborative healthcare teams. This ability makes the institution a magnet for pharmacy students and residents who want to dive into clinical pharmacy, she said.

Cutting-Edge Patient Care

The VA is just one of several distinct organizations operated by the federal government, including the Indian Health Service, National Institutes of Health, U.S. military, federal prisons, and the U.S. Department of Homeland Security’s Division of Immigration Health Services, where you’ll find ASHP members taking part in forward-thinking practices that emphasize clinical patient care, education, and counseling.

Over the years, ASHP has supported federal pharmacists with special continuing education forums at its Midyear Clinical Meeting and programs like free membership for pharmacists serving in Iraq. The Society also recently launched a staff committee to explore ways in which federal pharmacists could be prominently recognized for their professional promotions.

Carmichael points to the advocacy of Kenneth W. Kizer, M.D., MPH, who served as the VA under Secretary for Health in the 1990s, as a powerful catalyst for change at the VA.

“People attribute his tenure to changing the philosophy from a chaotic large organization to an organization that focuses on primary patient care and delivering high-quality care through performance measures,” Carmichael said. ASHP recognized Kizer’s achievements with a Board of Directors Award of Honor in 2002.

The VA’s reach in the U.S. is staggering. The organization estimates that about one-quarter of the nation’s population—74.5 million people—are potentially eligible for VA benefits because they are veterans or are either a family member or survivor of veterans. Comprised of 155 medical centers, the health system employs nearly 250,000 people who work with a growing patient population.

The VA has been the only organization where Kristina De Los Santos, Pharm.D., BCPS, has worked since receiving her doctor of pharmacy degree in 1999.

Improving Outcomes and Safety

De Los Santos is a pharmacy program manager for clinical services and the first-year pharmacy residency program director at the Southern Arizona VA Healthcare System in Tucson. When she worked in clinical practice, De Los Santos gave medical guidance to nurse practitioners and physicians and reviewed medication orders.

“I sometimes caught potential mistranslations of doses,” she said. “Pharmacists at the VA are in a position to really improve patient outcomes and safety.”

Robert Pittman, MPH, has dual roles as a federal pharmacist. He’s chief pharmacy officer for the U.S. Public Health Service, a position in which he advises the U.S. Surgeon General, and director of health professions for the Indian Health Service.

Pittman emphasizes the importance of having electronic access to his patients’ entire medical records.

“We have diagnoses, results of lab tests, notes from physicians. That’s all available for us to decide appropriate therapy” for the estimated 1.5 million American Indians and Alaska Native people treated at more than 300 clinics and 48 hospitals, Pittman said. “We think it’s the model for pharmacy in the future.”

First Educate…Then Advocate

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            You’ll notice on the next page a series of pictures of ASHP ’s recent Legislative Day, Sept. 27. In all, members held more than 100 meetings with Congress members and their legislative staff to educate them on pharmacists’ critical patient-care role.

            Members started early, with a breakfast meeting featuring Leigh Ann Ross, a pharmacist and healthcare legislative assistant in the office of Sen. Thad Cochran (R-Miss.). And they finished late—tired but excited to have connected with key decision makers.

            It’s an exhausting day—not just because of the long hours, but because we ask members to step far outside of their comfort zones. We ask them to be ready to talk about the Society’s legislative priorities and to transform themselves into lobbyists for a day. And it works! Because of what our members do each year, and the continual work of our government affairs staff, Congress is more aware of the ways in which pharmacists improve patient care.

            Whether you’re walking the halls of Congress or inviting a local representative into your hospital to observe how your pharmacy works, I believe it’s vital to educate, then advocate. I also believe that effective advocacy starts with certain assumptions, including that:

  • One person with an idea can initiate change,
  • Most legislators want to positively affect the lives of their constituents (aka your patients), and
  • Legislators are not well-versed in medication use, patient safety, pharmacists’ changing roles, or health-system pharmacy professional issues.

It’s up to all of us to educate decisionmakers, including our elected officials, about the best care for patients.

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