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April 24, 2020

New ASHP COVID-19 Updates

Dear Colleagues,

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

THE COVID-19 PANDEMIC CONTINUES to cause immense challenges across our nation. Today, I want to acknowledge the difficult situation facing many hospitals and health systems as a result of disruptions in routine or elective procedures and reductions in inpatient hospital stays. Of particular concern is the impact this situation is having on residency training.

Educating future generations of pharmacists is more critical than ever, and ASHP stands ready to support you in this time of need, including seeking ways to maximize the flexibility of our residency accreditation standards. Resident training is a critical component of pharmacy education, and we are hopeful that organizations will not furlough or terminate their current PGY1 and PGY2 pharmacy residents. Doing so could disrupt patient care and make residents ineligible for board certification and professional positions that require postgraduate pharmacy residency training. ASHP encourages accredited programs to adjust learning experiences in ways that give residents sufficient opportunities to complete their program.

We are here to assist you, and I encourage residency programs to reach out to Janet Silvester, vice president of Accreditation Services, or Stephen Ford, director of Residency Accreditation Services, for help. Please also read our guidance on the pandemic’s impact on residency training. We know how difficult things are right now, and ASHP wants to help you and your residents in any way we can.

Real-Time COVID-19 Information and Resources

ASHP continues to develop and disseminate important clinical guidance, real-time information, and lessons learned among pharmacists to help those working in current hot spots and to prepare others for potential patient surges.

Last week, we launched a weekly webinar series to provide information and guidance from your peers on the front lines, including live webinars offered by ASHP Consulting. Today’s live webinar from ASHP Consulting describes how health systems in Detroit and Southeastern Michigan — Beaumont Health, Ascension Michigan, and Henry Ford Health System — are managing supply chain and pharmacy operations during the pandemic. Please look for new webinars each week for an inside look at how pharmacists across the country are responding to the challenging circumstances surrounding this health crisis. Recorded versions of all webinars in ASHP’s COVID-19 webinar series are also available for those who can’t attend the live session.

Our popular daily @ASHPOfficial podcast continues to provide credible information on topics related to COVID-19. We have produced 25 episodes to date, with nearly 13,000 downloads of @ASHPOfficial in the past 30 days. We attribute this remarkable number to members and nonmembers taking a strong interest hearing about first-hand experiences from the front lines. We have listeners in every state in the country, indicating that ASHP members featured in the podcasts are reaching a broad healthcare community. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content packed with valuable information, personal experiences, and lessons learned from your colleagues with direct knowledge of COVID-19.

Our newly enhanced COVID-19 Resource Center is updated often with new and revised tools to assist all healthcare professionals in responding to patient needs across the continuum of care. ASHP’s Assessment of Evidence for COVID-19 Treatments, which has been downloaded more than 16,000 times, is updated at least twice weekly and provides clinical guidance to help frontline practitioners better understand current therapeutic approaches and recommended care for patients with COVID19. I encourage you to visit the Resource Center regularly to ensure you are using ASHP’s most up-to-date tools.

As medication experts, pharmacists are frontline patient care providers and trusted sources of information for patients. One of our most important roles is educating patients about their disease states and how to optimize their medications. This week, we added a special section to SafeMedication.com, ASHP’s consumer-focused website, with information about COVID-19 for patients and their families. The special section features consumer content in key areas, including how to treat mild cases of COVID-19 at home, an explanation of potential treatments for COVID-19, information about cloth face covers, and more. We will continue to enrich the site with pharmacist-written content to provide patients with a timely, accurate, and trustworthy source of information.

ASHP Survey and Advocacy

ASHP continues to survey our members about the latest developments related to essential pharmacy resources, such as personal protective equipment (PPE). Our latest survey also addresses the inventory status of intensive care unit (ICU) drugs needed to treat mechanically ventilated COVID-19 patients. We found that the ICU drugs with the most critical shortages include cisatracurium, fentanyl, ketamine, vecuronium, and midazolam. The full details of the survey results are available on the COVID-19 Resource Center.

ASHP continues to respond to member feedback by advocating for the increased production and availability of PPE and for solutions to drug shortages resulting from this public health emergency. We were encouraged by this week’s announcement from the Food and Drug Administration about new flexibilities for 503A pharmacies — including those in hospitals and health systems — and recent guidance for 503B outsourcing facilities to support increasing the supply of critical medications. ASHP will work closely with the agency to seek additional flexibilities as needed.

New Products to Meet Your Needs

In closing, while we continue to do everything we can to support you during the COVID-19 response, we remain committed to supporting you throughout all facets of your career. In that spirit, this week, ASHP launched a new Pharmacy Revenue Cycle Management Certificate, our newest self-guided, online certificate program designed to increase knowledge and skills in calculating reimbursement, documentation and billing, Medicare rules and regulations, and more. We know that tools like these are critical as many hospitals and health systems also face severe financial difficulties during this public health emergency. We will continue to develop products and services that will help our members gain important knowledge and meet continuing education needs.

As always, I extend my sincere thanks to you for being a member of ASHP and for everything that you are doing for your patients and our profession.

Sincerely,

Paul

 

April 3, 2020

ASHP Update on COVID-19

Dear Colleagues,

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

WEDNESDAY EVENING I had the opportunity to participate on a director of pharmacy roundtable call with members of the New York State Council of Health-System Pharmacists. On the call, the current situation on the ground and lessons learned regarding the COVID-19 pandemic were shared by New York City pharmacy leaders. These individuals and their teams are true healthcare heroes. They are dealing with patient care situations that are beyond compare. Patient care needs have required an increase of propofol, fentanyl, and midazolam utilization by 400-600% in the past 14 days as they manage the demands of the intensive care unit and ventilated patients. One healthcare system shared that three weeks ago, it had 18 COVID-19 positive patients. As of Wednesday, they had 1,100.

We have all watched and listened to reports from New York, New Jersey, and other COVID-19 epicenters responding to this national pandemic. Listening firsthand to the heroic efforts of pharmacists on the front lines underscores the urgent need to proactively provide data to our health system, local, state, and national leaders on the pharmacy staff resources and drug supply needed to meet the needs of our COVID-19 patients. These extraordinary times will require remarkable coordination and responsiveness among our industry partners and government agencies.

ASHP has put the full weight of our advocacy efforts toward resolving these issues. This week, ASHP and the American Hospital Association, the American Medical Association, the Association of Clinical Oncology, and the American Society of Anesthesiologists, sent a letter to the Drug Enforcement Administration (DEA) requesting an immediate increase in controlled substances (CII) annual production quota allocations to manufacturers and 503B outsourcing facilities to increase the supply of opioids critical to COVID-19 patients on ventilators. ASHP’s letter notes the tightening CII supply and the need to increase production of fentanyl, hydromorphone, and other supportive CIIs as quickly as possible to avoid exacerbating existing shortages. ASHP will continue to work with the DEA, the Food and Drug Administration, manufacturers, and distributors to provide hospitals with the CIIs and other medications that are in short supply and critically needed to treat patients during the COVID-19 response.

Yesterday we sent a letter to Vice President Mike Pence, imploring him to encourage agencies to coordinate their efforts to increase manufacturing capacity for critical medications, including opioids, sedatives, and paralytics, to the greatest extent possible.

A colleague in New York expressed that a “tsunami” of drug shortages is coming as more hospitals and health systems struggle to manage the exponential rise in patient load. It is ASHP’s number-one priority to keep this issue at the forefront of public attention, and we will activate all of our partners and resources to help ensure you have the medications your patients need.

Launch of New Free Service: ASHP CareerPharm Rapid Connect

ASHP has been working on many fronts to assist you, our members, and all healthcare professionals to combat the COVID-19 pandemic. We continue to create new resources to support your valuable work on the front lines of patient care.

As the impact of the pandemic escalates, we are hearing from healthcare organizations nationwide that pharmacy departments are struggling to keep pace with the demands of the growing COVID-19 patient population. In response, I am pleased to share that ASHP has quickly developed and launched a new free service, ASHP CareerPharm Rapid Connect, to help healthcare organizations connect with pharmacists who can provide critical services including surge support with temporary onsite staffing, remote medication order review, remote clinical pharmacy specialist services, and other staffing needs. ASHP’s CareerPharm Rapid Connect also will help organizations connect with pharmacy technicians. We hope this free service will provide opportunities for hospitals, health systems, and others to fill a growing demand for pharmacy personnel during this urgent time of need.

PPE Shortages

In addition to the troubling issue of drug shortages related to COVID-19 patient care, ASHP members and other healthcare providers continue to face shortages of personal protective equipment (PPE). As I noted in last week’s blog, we are continuously surveying our members to understand the real-time impact of this issue. According to our most recent survey results, 58% of respondents whose organizations perform sterile compounding reported the need to reuse masks, and 42% reported a major or moderate disruption in the availability of medical masks. This is a substantial increase from the first survey, where 15% of respondents indicated disruptions in their supplies. We will continue to survey this situation and provide you with updates in the weeks ahead.

Given the data, ASHP is advocating for increased production and supply of PPE to ensure pharmacy personnel and other healthcare providers have adequate protection from exposure. We also continue to advance ASHP’s policymaker recommendations that address shortages of PPE for pharmacists and drug shortages to Congress, HHS, and the Vice President’s COVID-19 Task Force. Over 5,000 ASHP members have contacted their members of Congress to share those recommendations. If you haven’t yet, please consider reaching out to your members of Congress to ensure your concerns are heard.

We also created a dedicated section on ASHP’s COVID-19 Resource Center with the latest sterile compounding and PPE guidance and health policy statements. Resources include additional tools that ASHP created to support your needs as well as guidance from others, including the United States Pharmacopeia Compounding Expert Committee’s recommendations in response to shortages of garb and PPE for sterile compounding.

In addition, we continue to work on creating tools and resources to protect and assist you, our members, and all healthcare professionals as you work on the front lines of patient care. Today, we released our newest recommendations for pharmacists and pharmacy technicians on ways to prevent exposure to COVID-19 while in the workplace as well as recommendations on how to protect your family and friends to reduce exposure at home. Given the rapidly evolving guidance and recommendations supporting this effort, we will be updating these materials regularly.

Extending the Reach and Impact of the ASHP Community

ASHP supports our members by serving as a professional home and facilitating a sense of community. During this challenging time, we’ve expanded that community to include and support the interprofessional teams that are working together to treat patients in the face of unprecedented challenges.

In this spirit, you may recall that a few weeks ago, we opened access to our evidence-based online resources and tools on ashp.org, making them widely available to all pharmacists and the broader healthcare community. It gives us great satisfaction to know that members and non-members alike are using and sharing many of our important COVID-19 resources. More than 32,000 professionals have taken advantage of our free offering of ASHP’s Critical Care Pharmacy Specialty Review Course, Practice Exam, and Core Therapeutic Modules package, including more than 24,000 who are not currently ASHP members.

ASHP will continuously offer credible, trusted resources and share best practices, advice, and experiences from those on the front lines across the country. We recently launched a daily COVID-19 podcast on our @ASHPOfficial podcast channel with episodes featuring ASHP members and pharmacy practice leaders who discuss the evolving clinical, operational, and leadership challenges surrounding the COVID-19 pandemic. In the latest podcast episode, nationally recognized drug shortage expert Erin R. Fox and ASHP experts share the most recent information on drug shortages related to COVID-19 and the impact the recent relief bill passed by federal legislators will have on managing the supply chain. I encourage you to subscribe to @ASHPOfficial to receive this free, timely content.

As a reminder, we also recently established a COVID-19 Connect Community that ASHP members — and all healthcare providers — can use to ask questions, receive answers, share experiences, post resources, receive updates, and learn best practices related to COVID-19. Since it was launched less than two weeks ago, this active community has grown to more than 51,000 members and has generated nearly 500 discussions. It’s a wealth of real-time, real-life information. Please join and participate if you haven’t already.

Summer Meetings

Finally, I’d like to address our decision announced earlier this week to cancel the Summer Meetings in June. Our top priority is the safety of our meeting participants and staff, and supporting your patients’ needs. We are working on a plan to deliver many of the important activities from the Summer Meetings virtually, including educational programming and the House of Delegates. We’ll share the details as they become available.

In the meantime, please take care of yourself and your families. Be assured that we will continue to work tirelessly on your behalf. Thank you for everything you do for your patients and the profession.

Sincerely,

Paul

March 12, 2020

ASHP Update on Activities During and in Response to the COVID-19 Pandemic

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

THE COVID-19 PANDEMIC is taking a major toll on people in the United States and around the world. The pandemic is taxing our entire healthcare system and public health apparatus and has or will affect all of our daily lives. ASHP wants you to know that we are here for you as you work on the front lines of patient care to help ensure your healthcare organizations are ready and that your patients get the best care possible. We understand that you and your loved ones may be at risk and the difficulty that this presents as you work to serve your communities and care for your patients during this crisis. We also know that the risks of drug shortages present major challenges in the care of your patients. ASHP and our colleagues at the University of Utah will continue to work to keep the ASHP Drug Shortages Resource Center updated, and we will continue to advocate on your behalf through continued outreach to policymakers as you stand ready to fight this public health emergency.

Last week, we developed two white papers detailing recommendations for federal and state policymakers to address the outbreak. Today, we also sent a letter to Vice President Mike Pence urging the Administration to take immediate steps to maximize pharmacist engagement in COVID-19 preparedness and response efforts. We also asked that decisive action by the Centers for Medicare & Medicaid Services be taken to remove barriers to pharmacists’ patient care services.

ASHP also developed a COVID-19 Resource Center, and we are continually updating it with new resources from various sources, including ASHP.

Due to the current COVID-19 developments, the “Safe, Effective, and Accessible High-Quality Medicines as a Matter of National Security” summit, originally planned for next week, will be postponed. We will be working with the other co-conveners, including the American Hospital Association, American Medical Association, and United States Pharmacopeia, to reschedule this important event in the coming months to continue to drive solution-focused recommendations that address global pharmaceutical manufacturing as a national security priority.

In addition, I would like you to know what we are doing to protect our staff, members and volunteers, and everyone we interact with at ASHP headquarters in Bethesda, Maryland. This includes preparing the organization for a scenario that could include closing our offices. However, we also recognize the need to be able to continue to serve our members even if our physical offices must be closed. We are prepared to run the organization remotely so that we can continue to work on your behalf and provide the tools and resources you need to care for your patients and yourselves.

Furthermore, I would like you to know that ASHP is also assessing all of our upcoming member events on a daily basis. The ASHP Regional Delegates Conferences that are taking place at the end of April in cities around the country are being planned to be held virtually if necessary.

In regard to the ASHP Summer Meetings that are scheduled to take place in Seattle in early June, it is too early to make a final decision. However, we will be fully prepared to make that difficult decision if there is any risk whatsoever to our participants. Safety comes first, no exceptions.

During this crisis, ASHP will remain focused on how we can best assist you, our members, and work at the local, state, and federal levels to be a partner in bringing this unfortunate public health crisis to an end. If you need our assistance, please don’t hesitate to contact ASHP. Please also continue to look to ASHP for up-to-date information and resources on the COVID-19 crisis. We will get through this difficult time together, and be stronger as a profession, citizens, and as a country and global community. In the meantime, ASHP will do everything we can to support you and the patients you serve.

Thank you for everything you do, and please know that we are here for you during this very difficult time.

Sincerely,

Paul

 

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