Current Issues Facing Hospital Pharmacies in 2023

The impacts of the COVID-19 pandemic on global health care are widespread and persistent. Hospital pharmacies have adapted with innovative solutions over the past few years, but the pandemic’s lingering effects continue to present challenges that permeate nearly every aspect of health care. From supply chain issues and staffing shortages to technological advances and emergency preparedness, we’re taking a look at the top challenges and current trends that are shaping the future of pharmacy.

The Current Issues Facing Hospital Pharmacies Today

1. Staffing Shortages

Recruiting and retaining pharmacists and pharmacy techs is one of the top concerns for hospital leadership. Several factors are influencing these staffing issues:

A severe shortage of pharmacy technicians

A majority of pharmacy administrators reported technician turnover rates of 21% to 30% as well as losing 41% or more of their technician workforce. Pharmacy techs are opting for higher paying positions at retail pharmacies or insurance companies instead of hospitals.

An imbalance of ingoing and outgoing workforce
Fewer students are enrolling in pharmacy schools and colleges. Over the past 10 years there has been a 60% decline in pharmacy school applications. Meanwhile, there’s been a surge in retirement for workers who initially delayed retirement due to the pandemic.

Changing attitudes about work
Prospective employees are looking for flexible scheduling as well as remote or work-from-home options like telehealth and virtual consultations.

Emerging trends for the role of pharmacists
During COVID-19, pharmacists took on a more visible role as essential frontline healthcare providers, providing vaccines and medication counseling. This will likely continue to expand in the future with pharmacists taking on a greater role in patient care.

Partnering with health-system HR professionals on recruiting strategies and developing pharmacy specific training platforms and options for new skills and competencies will help hospital pharmacies stay competitive.

See these articles from The Today Show and Forbes to learn more about pharmacy staff shortages.

2. Work Related Burnout & Stress

Increased demands and stressors on hospital pharmacy personnel lead to workplace burnout due to a number of factors. Pharmacists are taking up the slack due to high turnover rates of pharmacy techs. They are also stepping into a more prominent role as an essential healthcare provider. Recent research shows that patients are trusting their pharmacists with a larger role in their health care (i.e., prescribing medication, conducting screenings, and providing information about diagnosis and treatment).

These additional responsibilities, along with projected shortages of nurses, physicians, and other hospital staff, will likely find pharmacists with an overwhelming workload. In order to alleviate burnout while still maintaining quality pharmacy services, new strategies will need to be implemented, such as telehealth and virtual consultations, flexibility with scheduling, a renewed focus on salaries, and innovative plans for staff wellness and resilience.

3. Slow Financial Recovery

Many hospitals are struggling to get back on solid financial ground post-COVID. Billions of dollars were lost during the pandemic due to things like:
● Having to cancel more lucrative services and surgeries to prepare for COVID surges,
● The current inability to reopen floors due to nursing and other hospital staff shortages,
● Drug inventory shortages and pricing issues as well as time spent trying to find other products and substitutes.
● A “new normal” of simultaneous cases of COVID, flu, and RSV in addition to the ebbs and flows of flu season.

An analysis presented by Kaufman, Hall & Associates, LLC was released by the American Hospital Association in the fall of 2022, showing the financial challenges that hospitals and healthcare systems are facing. With expenses rising for everything from supplies and equipment to drugs and labor, “all categories are projected to remain approximately 20-25% above pre-pandemic levels, with drug and supplies increasing the most.”

The trends are expected to continue into 2023, but in order to address these financial challenges hospital pharmacy leaders must be focused on recovering patient volumes and revenues by honing their efficiency in purchasing, inventory, and other important areas. Manage costs and improving margins will help with financial recovery as well as instilling confidence in healthcare so that patients are more likely to return to hospitals for services.

4. Drug Pricing and Shortages

Drug prices continue to go up. The Kaufman analysis projected that drug expenses would grow by $1 billion in 2022. As an organization, CompleteRx is constantly monitoring the producer price index for prescription drugs. The past couple of years, levels have been around 1 to 1.5%, but as of December of last year they were up 4.6% or 4.8% and may even go as high as 7%.

In the year ahead significant drug pricing reforms will be rolled out in the U.S. – a result of the passage of the Inflation Reduction Act last year. However, lobbying groups are likely to present objections over how the law will actually be implemented, which may lead to further issues.

Inflation and supply chain costs have a trickle-down effect on drug pricing as well. In fact, supply chain costs represent the second largest expense for hospitals. Hospital pharmacies have always had to deal with pharmaceutical supply chain disruptions, but the pandemic magnified these issues. In particular it highlighted the challenges of predicting future disruptions and trying to develop strategies around purchasing decisions and stockpiling.

Being proactive and coming up with a systematic plan for drug purchasing and inventory control will help drive down costs and improve efficiency.

5. Technology & Automation

Technology continues to drive us into the future. The U.S. market for automation in pharmacy is expected to grow exponentially throughout the next decade. The automated dispensing cabinet market, alone, is expected to grow to $7.95 billion by 2030.

Automation, robots, AI, and software impact most aspects of healthcare, but in pharmacy in particular, they help to streamline workflow, reduce the risk of medication errors, help determine how we collect and use data to make decisions, and allow pharmacy staff to focus on and improve personalized and direct patient care.

To make the most of technology, pharmacy leaders should prepare and train staff how to use and leverage technology for patient care and pharmacy services. They also need to be aware of challenges such as safe and effective use, especially regarding accuracy and bias, and understand the potential for both benefits and harm.

6. Cybersecurity

For all of its exciting benefits, one of the biggest challenges of our increased reliance on technology is cybersecurity. As healthcare expands with things like telehealth and electronic records, the risk of cyberattack grows exponentially.

Cybersecurity may be an expensive investment, but the costs of not implementing it are unthinkable. Cyberattacks and data breaches not only put patients’ data – and possibly lives – at risk, but they can shut down entire healthcare organizations, resulting in a loss of millions of dollars.

Hospital pharmacy leaders must make cybersecurity a top priority in order to maintain tight security, address concerns about data breaches, and ensure preparations for when the system inevitably goes down. In the event of a cyberattack, it is key for hospital pharmacies to have a good incident response plan that details exactly what to do and who should do it so that they can continue to operate.

Examples could be initiating internal triage processes or implementing regularly occurring downtime procedures that happen when systems are being updated. Personnel should be prepared to switch to a paper-based system and then have a strategy for converting those documents back into a digital form once all systems are reactivated. Periodic testing of the response plan will ensure that pharmacies are ready if a cyberattack should happen.

7. Telehealth

Telehealth has been around for well over a decade, but the COVID-19 pandemic pushed it to the forefront, allowing patients easy access to their healthcare providers. The trend seems to be here to stay. A recent report shows 90% of patients utilized a patient portal to electronically access their medical information such as labs and test results. And evidence suggests that access to virtual care has a positive impact on the quality of patient care as well as limiting the loss of revenue on the hospital side.

With the telehealth market set to reach $787.4 billion by 2028,, hospital pharmacy leaders should keep a few things in mind. Consider ways to expand patient-centered care through telehealth platforms, providing easy access to pharmacists. Incorporate “pharmacy services without walls” into all future strategic planning and ensure that cybersecurity measures are taken to keep patient information safe.

8. New Regulations for 2023

As new technologies and medications emerge in the pharmaceutical and healthcare industries, so will new regulations. One of the newest guidelines put out by the U.S. government is the USP 797/800.

Under this guideline, any facilities, including hospital pharmacies, where compounded sterile preparations such as IV mixtures or liquids are prepared, stored, and dispensed will require specific conditions such as:
● an anteroom with special filtration before going into the room where the products are actually prepared,
● sterile gowns and gloves,
● a biological safety cabinet to blow air upward and away from the product,
● special paint, seamless floor tiles, stainless steel, pressurized areas, etc.,
● no makeup or jewelry,
● and particulate testing must be done on a regular basis.

Hospital pharmacies can adapt to the USP 797/800 as well as any other regulations or guidelines by ensuring they stay informed and that their staff undergo strict training and testing on all procedures. A major challenge for many hospitals is the construction projects to meet the physical environment requirements, many have not have the finances to fund these capital improvement projects. Regardless, the regulations will be enforced starting in November of this year, so there is still time.

9. Reclaiming Trust in Public Health

One of the most difficult impacts of COVID-19 was the marked decline in trust of public health officials. Though there are many reasons for the decline – mistrust of medical authorities, lack of confidence in government leadership, political polarization, and conspiracy theories – medical misinformation is now considered a public health emergency.

Hospital pharmacies, along with the entire health system, must strive to address and restore the lack of trust immediately and with thoughtful determination. This includes:
● Collaborating with community organizations and utilizing the voices of trusted health professionals,
● making science-based health and medical information easily accessible to consumers,
● understanding that addressing medical misinformation is a moral and civic responsibility for all healthcare providers.

10. Emergency Preparedness

Health care systems have historically prepared to meet a given threat to specific systems or services, but COVID-19 presented a systemic emergency to not only the entire healthcare system but the global society as well. With multiple challenges converging at once, the pandemic highlighted the importance of being prepared for unanticipated disasters and having a plan that is regularly reviewed and updated.

It is crucial that we learn from our experiences and proactively prepare for future threats. An effective disaster plan for hospital pharmacies should address how to manage things like drug supply chain disruptions, staffing shortages, including who will perform critical pharmacy functions, workplace stressors, and patient care services.

If you need assistance addressing any of these issues facing hospital pharmacies, please reach out to speak with one of our team.