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9/6/2000
Press Release

ASHP House of Delegates Takes Action on Broad Range of Professional Issues

The American Society of Health-System Pharmacists (ASHP) House of Delegates considered a variety of pharmacy issues at its 51st annual session, including compliance with governmental payment policies; optimizing the medication-use process; use of machine-readable code technology; pharmacists' roles in drug procurement, distribution, and control; reporting medication errors and adverse drug reactions; telepharmacy; and pharmacist validation of public information related to medications. The session, held June 7 and 9 in Reno, Nev., was conducted in conjunction with the Society's Annual Meeting '99.

The House of Delegates, ASHP's chief policy-making body, consists of 161 voting state delegates (a minimum of two from each state and the District of Columbia). Voting delegates also include the members of the Board of Directors, past presidents of ASHP, and two student delegates. 

POLICY ACTIONS 

The House approved the following professional policies, which originated from ASHP councils as noted: 

Council on Administrative Affairs 

Fostering Pharmacy Leadership. To encourage pharmacy managers to serve as mentors to their staff, pharmacy students, pharmacy residents, and peers in a manner that fosters the development of future pharmacy leaders. 

Compliance with Governmental Payment Policies. To encourage pharmacy managers to identify and resolve medication-related billing issues in government health care programs that could cause challenges under fraud and abuse laws; further, to encourage pharmacy managers to establish an internal audit system for medication-related services, in conjunction with their corporate compliance programs, in order to meet the requirements of government health care payment policies. 

Optimizing the Medication-Use Process. To urge health-system pharmacists to assume leadership, responsibility, and accountability for the quality, effectiveness, and efficiency of the entire medication-use process (including prescribing, dispensing, administration, monitoring, and education) across the continuum of care; further, to urge health-system pharmacists to work in collaboration with patients, prescribers, nurses, and other health care providers in improving the medication-use process. 

Emergency Preparedness. To encourage health-system pharmacists to establish emergency plans within their practice site and local community to address the public's medication needs in the event of biological or chemical terrorist attacks or other disasters; further, to encourage health-system pharmacists to establish appropriate local, state, and national contacts for providing the information and supplies needed to address emergencies related to biological and chemical terrorism or other disasters; further, to work with various agencies, including the Centers for Disease Control and Prevention, the Federal Emergency Management Agency, and the Public Health Service, to advocate the need for pharmacist participation in developing and planning procedures for responding to natural, biological, and chemical public health emergencies. 

Diversifying Pharmaceutical Services. To encourage health-system pharmacy managers to assess the development and marketing of diversified pharmaceutical services (e.g., home care, ambulatory care), consistent with the mission of their health system; further, to include in such assessments consideration of patients' needs for comprehensive and continuous pharmaceutical care, cost-effectiveness of services, risk management, ethical principles, and legal issues. 

Use of Machine-Readable Code Technology. To support the application of machine-readable codes in health systems; further, to evaluate the current state of this technology and the benefits that it offers to the medication-use process; further, to advocate that all drug product packaging include a machine-readable code in a manner that identifies the package contents (including lot numbers and expiration dates) and improves patient safety. 

Workload and Productivity Monitoring and Reporting. To advocate the implementation of a pharmacy productivity monitoring system that analyzes productivity changes in terms of their impact on patient outcome; further, to continue communications with health-system administrators, consulting firms, and professional associations on the value of pharmaceutical services and on the use of accurate data to assess pharmacy productivity and staffing levels; further, to encourage practitioners and computer software vendors to develop and use a standard protocol for collecting and reporting pharmacy workload data; further, to advocate to health-system administrators, consulting firms, and computer software vendors the use of valid workload and productivity measurement systems for pharmacy patient care services. 

Pharmacists' Role in Drug Procurement, Distribution, and Control. To affirm the pharmacists' expertise and responsibility in the procurement, distribution, and control of all drug products used within the health system, including investigational agents and medications brought into the system by the patient; further, to encourage the Joint Commission on Accreditation of Healthcare Organizations, other accreditation bodies, and governmental entities to assure the pharmacist's role in drug procurement, distribution, and control. 

Electronic Information Systems. To advocate the use of electronic systems with appropriate security controls, that enable the sharing of patient-specific data among the components of a health system; further, to expect computer software vendors and pharmaceutical suppliers to use a standard coding format for electronic information systems that is consistent with the needs of pharmacy services in a health system; further, to advocate the development of both formal and informal liaisons with appropriate health care associations to ensure that the interests of pharmacy are fully represented in the implementation of electronic information systems; further, to strongly encourage health-system administrators, regulatory bodies, and other appropriate groups to provide health-system pharmacists with full access to patient-specific clinical data. 

Pharmacists' Documentation of Pharmaceutical Care. To encourage pharmacists to document the provision of pharmaceutical care and validate the impact of pharmaceutical care on patient outcomes. 

Council on Educational Affairs 

Expanding Pharmacy Residency Training. To continue efforts to increase the number of pharmacy residency training programs and positions available; further, to expand efforts to make pharmacy students aware early in their education of the career choices available to them and the importance health-system employers attach to the completion of a residency. 

Uniform Standards for Pharmacy Technician Education and Training. To support the concept of uniform standards for the education and training of all pharmacy technicians; further, to take a leadership role in advocating the development and adoption of uniform standards for the education and training of all pharmacy technicians. 

Leadership Development in Colleges of Pharmacy. To encourage colleges of pharmacy to include leadership skills in professional curricula; further, to encourage colleges of pharmacy to offer combined residency-degree programs to develop pharmacy leaders; further, to encourage colleges of pharmacy to develop more opportunities for students to pursue combined degree programs (e.g., Pharm.D.—M.B.A.) that develop administrative, management, and leadership skills in addition to pharmacy education. 

Teaching How to Provide Interdisciplinary Patient Care. To encourage colleges of pharmacy to focus on the need to train students in the skills needed to work with other health care professionals to provide patient care; further, to encourage the American Council on Pharmaceutical Education to include standards relating to teaching the delivery of interdisciplinary pharmaceutical care in the next revision of accreditation standards for colleges of pharmacy; further, to encourage pharmacists to collaborate with other health professionals in the development of purposeful, deliberative interdisciplinary care models. 

Council on Legal and Public Affairs 

ASHP Position on Assisted Suicide. To remain neutral on the issue of health professional participation in assisted suicide of patients who are terminally ill; further, to offer guidance to health-system pharmacists who practice in states in which assisted suicide is legal. 

Reporting Medication Errors and Adverse Drug Reactions (revises previous ASHP policy). To encourage pharmacists to exert leadership in establishing a nonthreatening, confidential atmosphere in their work places to encourage pharmacy staff and others to report actual and suspected medication errors and adverse drug reactions in a timely manner; further, to provide leadership in supporting a single, comprehensive medication error reporting program that (a) fosters a confidential, nonthreatening, and nonpunitive environment for the submission of medication error reports; (b) receives and analyzes these confidential reports to identify system-based causes of medication errors or potential errors; and (c) recommends and disseminates error prevention strategies; further, to provide leadership in encouraging the participation of all stakeholders in the reporting of medication errors to this designated program. 

Management of Blood Products and Derivatives. To strongly encourage the computer software industry to provide data fields for lot number, expiration date, and other necessary and appropriate information for blood products and derivatives and biologicals, in order to facilitate compliance with regulatory requirements concerning the use of these products, particularly with respect to recalls or withdrawals. 

The Council on Legal and Public Affairs also approved the ASHP Statement on Pharmacist Decision-making in Assisted Suicide and the ASHP Statement on Confidentiality of Patient Health Care Information. 

Telepharmacy. To foster among health-system pharmacists and leaders of the telecommunications industry a common vision for the integration of telecommunication technology into the delivery of pharmaceutical care. 

Pharmacist Validation of Public Information Related to Medications. To support consultation with a pharmacist as a primary means for consumers to validate publicly available information related to medications. 

The Council on Professional Affairs also approved the ASHP Statement on the Pharmacists' Role in Primary Care. 

NEW BUSINESS 

Delegates approved for referral to the Board of Directors six New Business items dealing with professional issues, including compliance of advanced practice credentialing programs with the standards of the Council of Credentialing in Pharmacy; use of the term "pharmacist care" in lieu of "pharmaceutical care"; addressing the issue of medication shortages; achieving statutory protection for medication error reporting; investigating the distribution of short-supply pharmaceutical products; and compensation for the provision of pharmaceutical care and other cognitive services. 

RECOMMENDATIONS

The House of Delegates also offered 31 recommendations for review by the Board of Directors and referral to appropriate ASHP bodies for study during the coming year. 

ASHP is the 30,000-member national professional association that represents pharmacists who practice in hospitals, health maintenance organizations, long-term care facilities, home care, and other components of health care systems. ASHP believes that the mission of pharmacists is to help people make the best use of medications. Assisting pharmacists in fulfilling this mission is ASHP's primary objective. The Society has extensive publishing and educational programs designed to help members improve their delivery of pharmaceutical care, and it is the national accrediting organization for pharmacy residency and pharmacy technician training programs.