Chesapeake Regional Healthcare

Amy Schultz is an accomplished pharmacist with extensive experience within the industry. Apart from being the director of pharmacy for Chesapeake Regional Healthcare, she is also a delegate at Virginia Society of Health System Pharmacists.

In an exclusive interview with MedTech Outlook, she shared her invaluable insights regarding drug supply, the transformations and challenges within the sector, along with the possible solutions.

Could you talk about your background, experiences and current role at Chesapeake Regional Healthcare?

I am a pharmacist with a background in emergency medicine and informatics. I completed my pharmacy education at Virginia Commonwealth University School of Pharmacy and pursued residencies at Grady Health System in Atlanta, Georgia. I worked as a frontline pharmacist before transitioning to leadership roles, with a focus on emergency medicine.

Currently, I am in my fifth year as director of pharmacy at Chesapeake Regional Health Care, and this is my second directorial job. Chesapeake Regional Health Care is my home community, and I specifically took the job to serve the people I have known for a long time.

As the director of pharmacy, I oversee the entire pharmacy enterprise, including community pharmacies, inpatient pharmacy, infusion center, and clinical pharmacy services. On a daily basis, my responsibilities range from human resources functions such as hiring and team building to financial tasks like budgeting, invoicing, and payment processing. I engage in strategic planning to align pharmacy services with community needs, integrate them into the hospital and health system strategy, and ensure compliance with state and federal regulations. Additionally, I oversee operations and regulatory matters to maintain a high standard of compliance.

What would you say are some of the prevailing challenges in the drug delivery sector?

A major challenge in drug delivery is the ongoing issue of unprecedented drug shortages, often unpredictable and exacerbated by external events, such as natural disasters affecting production. Managing these drug shortages is labor-intensive, and is made complicated by communication hurdles in conveying plans to the entire staff.

“Meaningful problem-solving often arises from exchanging ideas and experiences with others, learning about effective strategies, and understanding what hasn't worked.” 

Additionally, the integrity of the drug supply chain is a growing concern. The impending Drug Supply Chain Security Act (DSCSA) addresses this by mandating rigorous tracking of medication pedigree from source to patient. The DSCSA aims to ensure that medications reach intended recipients without theft or unauthorized diversion along the supply chain.

We have also implemented Radio Frequency Identification (RFID) technology, specifically in our emergency department for medications related to cardiac arrest. This technology utilizes special barcodes on medications to enable efficient tracking, inventory monitoring, and swift response to product recalls or expired medications.

Another area of focus is the Intravenous (IV) room, a critical space in hospitals or infusion centers where intravenous medications are prepared. The medication safety community is advocating for the elimination of syringe pullback, a method prone to medication errors. To enhance safety, we are exploring the implementation of volumetric checking, leveraging camera technology to capture a photographic record of the medication preparation. This approach allows pharmacists to visually inspect the entire process, ensuring accuracy. Additionally, technologies like gravimetric checking, involving scales and specific gravity calculations, are being considered for further accuracy in measuring medication quantities. The evolving landscape of medication safety technology is notably evident in the context of IV rooms in healthcare facilities.

Could you talk about a recent project where you implemented some best practices which led to some really good outcomes?

We successfully implemented RFID technology, beginning with our code kits used in treating cardiac emergencies. To ensure alignment with current guidelines, we thoroughly reviewed and updated the kit's contents, verifying both the quantity and types of medications. We then partnered with our drug wholesaler to streamline the implementation process. The medications in each tray now come with an RFID barcode, allowing us to create a comprehensive record of the kit's contents during assembly. This technology enables efficient tracking of trays throughout the hospital, providing real-time information on medication status and expiration dates.

The benefits of this implementation are twofold. Firstly, it enhances patient safety by facilitating swift response to drug recalls, expirations, or other issues. Secondly, it enables cost-effective inventory management, allowing us to precisely track medication usage from each kit.

Following the success in the emergency room, we plan to expand this technology to include other kits, such as stroke kits, and integrate it into trays used in anesthesia in our operating rooms. This expansion aims to replicate the success achieved in the initial implementation, ensuring a standardized and efficient approach across various medical contexts.

What are some of the new technologies that you are looking forward to in the next 12 to 18 months?

The current pharmacy workforce is experiencing shortages on a national scale, affecting both technicians and pharmacists. Given the strain on labor resources, it is prudent for pharmacies to explore technologies that alleviate this burden. Solutions that streamline and simplify the roles of pharmacists and technicians are particularly valuable in this labor market.

In light of these challenges, any AI-driven tool designed to address issues like predicting and managing drug shortages or assisting pharmacists in handling complex patients are highly beneficial. Algorithms based on guidelines that enhance the efficiency of pharmacists' tasks can significantly contribute to managing workflow during periods of labor shortages.

What is your advice to peers and aspiring professionals in the industry?

I would advise them about the value of networking and engaging in dialogues with colleagues at both state and national levels. The labor shortages and challenges prevalent in the industry affect everyone on a national scale. Meaningful problem-solving often arises from exchanging ideas and experiences with others, learning about effective strategies, and understanding what hasn't worked. By actively participating in such networking opportunities, individuals can gather valuable insights and bring back best practices to enhance their own organizations.

Is there anything else that you would like to mention?

As far as the issue concerning the supply chain integrity is concerned I think it is important to highlight the context of the opioid crisis that we encountered. Given the imperative to prevent drug diversion, many organizations prioritize measures to address this issue.

In our health system, we took a significant step by replacing all the outdated refrigerators with modern, automated dispensing cabinet-based refrigerators. Unlike traditional lock-and-key refrigerators, these new units feature compartments that enable precise control over access to each medication. This investment has enhanced patient safety by preventing mix-ups and serves as a strategic measure to combat diversion.