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Pharmacy Directors Name Staffing, Cost Control As Top Challenges

Donna Young

Staffing shortages and cost-control issues are, far and away, the biggest practice-related challenges facing health-system pharmacy directors, according to a recent snapshot of opinions obtained by the American Society of Health-System Pharmacists (ASHP).

As part of a survey of pharmacy practice managers conducted in November 2001, ASHP’s market researchers asked respondents to name their top three practice challenges at the time. The participants were not prompted with examples.

Douglas Scheckelhoff, M.S., ASHP’s practice leadership and management director, said the 300 respondents identified 676 practice-related challenges, which were categorized into 20 distinct issues. More than 80 percent of the respondents identified themselves as health-system pharmacy directors.

The pharmacist shortage, including problems with recruitment and retention, topped the list of issues. Twenty-five percent of the respondents identified this personnel shortage as their greatest challenge. Close behind were budget issues, mentioned by 24 percent of the respondents.

Problems with billing and reimbursement, medication safety, drug shortages, automation, personnel management, and the formulary were mentioned by relatively few of the respondents, compared with the top two challenges identified in the survey.

"What’s most significant about the practice challenges is the top two dwarf everything else on the list," Scheckelhoff said. "Other things may be issues for [the respondents], but they’re not as significant. They didn’t necessarily come to mind."

Every pharmacy director who responded to the survey may not personally "wrestle" with each practice-related issue identified by the group, Scheckelhoff said. For example, drug shortages "may not be as big of an issue as just keeping their place afloat with staff," he said.

Then there is the much-publicized Health Insurance Portability and Accountability Act of 1996 (HIPAA), hardly mentioned by the respondents.

"The scope of the HIPAA issue to most places is relatively small in comparison to the day-to-day issues of staffing and budget and so forth," he said. "I think [pharmacists] are dealing with it, especially if they have outpatient pharmacies and have different places where data security and access to data is an issue." But he speculated that HIPAA-related concerns will not make the list of top 10 practice-related challenges so long as staffing shortages and other higher priority issues remain.

ASHP researchers did not consider hospital bed size or regional differences when looking at the survey responses, Scheckelhoff said.

Elizabeth J. Kelly, B.A., ASHP’s market research manager, led the survey project.