Pharmacy Management

Compensation and Reimbursement

Human Resources

Source: Council on Administrative Affairs

To affirm the importance of an organizational structure in hospitals and health systems that places administrative, clinical, and operational responsibility for the pharmacy department under a pharmacist leader.

Source: Council on Administrative Affairs

To encourage pharmacy managers to consider workload fatigue, length of shifts, and similar performance-altering factors when scheduling pharmacy staff, in order to ensure safe pharmacy practices; further,

To oppose state or federal laws or regulations that mandate or restrict work hours for pharmacy staff; further,

To support research on the effects of shift length, fatigue, and other factors on the safe practice of pharmacy.

Source: Council on Administrative Affairs

To advocate the development and implementation of a pharmacy workload monitoring system that analyzes the impact of pharmacy services on patient outcomes; further,

To define pharmacy workload as all activities related to providing pharmacy patient care services; further,

To continue communications with health-system administrators, consulting firms, and professional associations on the value of pharmacists' services and on the use of valid and reliable data to assess pharmacy workload and staffing effectiveness; further,

To encourage practitioners and vendors to develop and use a standard protocol for collecting and reporting pharmacy workload data and patient outcomes; further,

To advocate to health-system administrators, consulting firms, and vendors of performance-measurement services firms the use of comprehensive pharmacy workload and staffing effectiveness measurements.

This policy supersedes ASHP policy 9907.

Compensation and Reimbursement

Source: Council on Pharmacy Management

To support pay-for-performance reimbursement models when they are appropriately structured to improve health care quality; further,

To oppose pay-for-performance reimbursement models that do not support an open culture of medication error reporting; further,

To encourage pharmacists to actively lead medication-related pay-for-performance initiatives.

Source: Council on Administrative Affairs

To support third-party reimbursement for FDA-approved drug products appropriately prescribed for unlabeled uses.

This policy was reviewed in 2006 by the Council on Pharmacy Management and by the Board of Directors and was found to still be appropriate.

Source: Council on Administrative Affairs

To pursue, in collaboration with public and private payers, the development of improved methods of reimbursing pharmacies for the cost of drug products dispensed and associated overhead; further,

To educate pharmacists about those methods; further,

To pursue, with federal and state health-benefit programs and other third-party payers, the development of a standard mechanism for compensation of pharmacists for patient care services and compounding and dispensing services; further,

To pursue changes in federal, state, and third-party payment programs to (1) define pharmacists as providers of patient care and (2) issue provider numbers to pharmacists that allow them to bill for patient care services; further,

To educate and assist pharmacists in their efforts to attain provider status and receive compensation for patient care services.

This policy was reviewed in 2006 by the Council on Pharmacy Management and by the Board of Directors and was found to still be appropriate.

Human Resources

Source: Council on Public Policy

To advocate that federal, state, and local governments recognize the risks and consequences of workplace violence in the pharmacy community and enact appropriate criminal penalties; further,

To collaborate with federal, state, and local law enforcement and other government authorities on methods for early detection and prevention of workplace violence; further,

To encourage all workplace environments to develop and implement a policy for pharmacy personnel that (1) educates about prevention and deterrence of workplace violence, (2) identifies escalating situations that can lead to violence and instructs employees on protection and self-defense, and (3) provides continued support and care to heal personnel who were directly or indirectly involved in an incident of workplace violence; further,

To encourage the health care community to develop and maintain a communication network to share information about incidents of potential and real workplace violence.

Source: Council on Public Policy

To advocate that pharmacists at each practice site base the site’s pharmacist and technician staffing levels on patient safety considerations, taking into account factors such as (1) acuity of care, (2) breadth of services, (3) historical safety data, and (4) results of research on the relationship between staffing patterns and patient safety; further,

To advocate that regulatory bodies not mandate specific, uniform pharmacy personnel ratios but rather ensure that site-specific staffing levels optimize patient safety; further,

To encourage additional research on the relationship between pharmacy staffing patterns and patient safety.

This policy supersedes ASHP policy 0717.

Source: Council on Education and Workforce Development

To sustain and enhance the public information program promoting the professional image of hospital and health-system pharmacists to the general public, public policymakers, payers, other health care professionals, and hospital and health-system decision-makers; further,

To provide ASHP informational and recruitment materials identifying opportunities for pharmacy careers in hospitals and health systems.

This policy supersedes ASHP policy 0214.

Source: Council on Pharmacy Practice

To discourage the use and distribution of tobacco and tobacco products in and by pharmacies; further,

To advocate for tobacco-free environments in hospitals and health systems; further,

To seek, within the bounds of public law and policy, to eliminate the use and distribution of tobacco and tobacco products in meeting rooms and corridors at ASHP-sponsored events; further,

To promote the role of pharmacists in tobacco-cessation counseling; further,

To join with other interested organizations in statements and expressions of opposition to the use of tobacco and tobacco products.

This policy supersedes ASHP policy 8807.

Source: Council on Professional Affairs

To advocate that hospitals and health systems require health care workers to receive an annual influenza vaccination except when (1) it is contraindicated, or (2) the worker has religious objections, or (3) the worker signs an informed declination; further,

To encourage all hospital and health-system pharmacy personnel to be vaccinated against influenza; further,

To encourage hospital and health-system pharmacists to take a lead role in developing and implementing policies and procedures for vaccinating health care workers and in providing education on the patient safety benefits of annual influenza vaccination; further,

To work with the federal government and others to improve the vaccine development and supply system in order to ensure a consistent and adequate supply of influenza virus vaccine.

Source: Council on Administrative Affairs

To foster the systematic and ongoing development of management skills for health-system pharmacists in the areas of (1) health-system economics, (2) business plan development, (3) financial analysis, (4) pharmacoeconomic analysis, (5) diversified pharmacy services, and (6) compensation for pharmacists' patient-care services; further,

To encourage colleges of pharmacy to incorporate these management areas in course work and clerkships.

This policy supersedes ASHP policy 0003.

Source: Council on Educational Affairs

To recognize that providing professional development opportunities for health-system pharmacy practitioners is an essential component of staff recruitment and retention as well as quality of work life; further,

To strongly encourage health-system pharmacy directors and administrators to support professional development programs as an employee benefit that ultimately improves patient care and aids in recruiting and retaining qualified practitioners; further,

To recognize that professional development encompasses more than staff development programming and includes informal learning among colleagues, mentoring, and other types of learning; further,

To develop educational programs, services, and resources to assist health-system pharmacies in supporting professional development.

Source: Council on Legal and Public Affairs

To reaffirm the following statement in the White Paper on Pharmacy Technicians (April 1996) endorsed by ASHP and the American Pharmacists Association:

"Although there is a compelling need for pharmacists to expand the purview of their professional practice, there is also a need for pharmacists to maintain control over all aspects of drug product handling in the patient care arena, including dispensing and compounding. No other discipline is as well qualified to ensure pubic safety in this important aspect of health care."

Further,

To oppose the creation of new categories of licensed pharmacy personnel; further,

To advocate that all professional pharmacy functions be performed under the supervision of a licensed pharmacist to avoid confusion regarding the roles of pharmacy personnel within health systems.

This policy supersedes ASHP policy 0025.

Source: Council on Educational Affairs

To foster awareness of the cultural diversity of health care providers; further,

To foster recognition of the impact that cultural diversity of health care providers may have on the medication-use process; further,

To develop the cultural competencies of pharmacy practitioners, technicians, students, and educators.

Source: Council on Legal and Public Affairs

To recognize licensure of pharmacists as the only state-imposed legal requirement necessary for pharmacists engaged in providing collaborative drug therapy management services; further,

To support the current practice of pharmacists and prescribers negotiating and establishing collaborative drug therapy management agreements in which the pharmacist receives delegated authority; further,

To support the use of privileging processes in those practice environments where explicit privileging is required to receive delegated authority; any additional training or credentials required of pharmacists engaging in these practices should be determined by the local practice site; further,

To stipulate that privileging should be conducted by an oversight body of the practice site.

(Note: Privileging is the process by which an oversight body of a health care organization or other appropriate provider body, having reviewed an individual health care provider's credentials and performance and found them satisfactory, authorizes that individual to perform a specific scope of patient care services within that setting.)

This policy was reviewed in 2007 by the Council on Public Policy and by the Board of Directors and was found to still be appropriate.

Source: Council on Administrative Affairs

To encourage pharmacy managers to work in collaboration with physicians, nurses, health-system administrators, and others to outline key pharmacist services that are essential to safe and effective patient care; further,

To encourage pharmacy managers to be innovative in their approach and to factor into their thinking legal requirements, accreditation standards, professional standards of practice, and the resources and technology available in individual settings; further,

To support the following principles:

• Sufficient qualified staff must exist to ensure safe and effective patient care;
• During periods of staff shortages, pharmacists must exert leadership in directing resources to services that are the most essential to safe and effective patient care;
• Within their own organizations, pharmacists should develop contingency plans to be implemented in the event of insufficient staff—actions that will preserve services that are the most essential to safe and effective patient care and will, as necessary, curtail other services; and
• Among the essential services for safe and effective patient care is pharmacist review of new medication orders before the administration of first doses; in settings where patient acuity requires that reviews of new medication orders be conducted at any hour and similar medication-use decisions be made at any hour, there must be 24-hour access to a pharmacist.

This policy was reviewed in 2006 by the Council on Pharmacy Management and by the Board of Directors and was found to still be appropriate.

Source: Council on Educational Affairs

To promote the image of pharmacy technicians as valuable contributors to health care delivery; further,

To develop and disseminate information about career opportunities that enhance the recruitment and retention of qualified pharmacy technicians.

This policy was reviewed in 2006 by the Council on Education and Workforce Development and by the Board of Directors and was found to still be appropriate.

Source: Council on Legal and Public Affairs

To support federal and state incentive programs for new pharmacy graduates to practice in underserved areas; further,

To provide information and educational programming on strategies used by employers for successful recruitment and retention of pharmacists and pharmacy technicians; further,

To conduct regular surveys on trends in the health-system pharmacy work force, including retention rates for pharmacists and pharmacy technicians.

This policy was reviewed in 2006 by the Council on Public Policy and by the Board of Directors and was found to still be appropriate.

Source: Council on Educational Affairs

To encourage pharmacists to serve as mentors to students, residents, and colleagues in a manner that fosters the adoption of: a) high professional aspirations for pharmacy practice, b) high personal standards of integrity and competence, c) a commitment to serve humanity, d) habits of analytical thinking and ethical reasoning, and e) a commitment to lifelong learning.

This policy was reviewed in 2005 by the Council on Educational Affairs and by the Board of Directors and was found to still be appropriate.

Source: Council on Educational Affairs

To recognize that pharmacy department staff development is an essential component of staff recruitment and retention as well as quality of work life; further,

To recognize that staff development encompasses more than formal in service or external programs and includes informal learning among colleagues, mentoring, and other types of learning; further,

To strongly encourage pharmacy directors and health-system administrators to support staff development programs as an important benefit that aids in recruiting and retaining qualified practitioners; further,

To assist pharmacy directors with staff development initiatives by providing a variety of educational programs, services, and resource materials.

This policy was reviewed in 2005 by the Council on Educational Affairs and by the Board of Directors and was found to still be appropriate.

Source: Council on Educational Affairs

To support the position that credentialing is a voluntary professional activity distinct and separate from the licensing process; further,

To endorse the goals and the standards-based approach to credentialing being pursued by the Council on Credentialing in Pharmacy (CCP); further,

To support the position that all widely accepted post licensure pharmacy credentialing programs must meet quality standards that are being established by CCP.

This policy was reviewed in 2005 by the Council on Educational Affairs and by the Board of Directors and was found to still be appropriate.

Source: Council on Legal and Public Affairs

To recognize the use of pre-employment drug testing or drug testing for cause during employment based on defined criteria and with appropriate validation procedures; further,

To support employer-sponsored drug programs that include a policy and process that promote the recovery of impaired individuals.

This policy was reviewed in 2006 by the Council on Public Policy and by the Board of Directors and was found to still be appropriate.

Source: Council on Legal and Public Affairs

To oppose the use of truth-verification testing such as polygraphs as routine employment practices because of the possible interference with the rights of individuals; further,

To recognize the limited use of such testing during employment where such testing may protect the rights of individuals against false witness.

This policy was reviewed in 2006 by the Council on Public Policy and by the Board of Directors and was found to still be appropriate.

Source: Council on Legal and Public Affairs

To work toward the removal of legislative and regulatory barriers preventing pharmacists from delegating certain technical activities to other trained personnel.

This policy was reviewed in 2006 by the Council on Public Policy and by the Board of Directors and was found to still be appropriate.