Prevalence and risk factors of burnout in community pharmacists.

OBJECTIVES: This study aimed to identify the prevalence and risk factors for occupational burnout in community pharmacists. METHODS: Community pharmacists were solicited through a professional network e-mail Listserv to complete an anonymous, electronic survey on burnout. The survey included the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and a work-factors-based questionnaire. The MBI-HSS assessed burnout on the basis of feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment. The additional questionnaire was used to evaluate risk factors for burnout by collecting information on pharmacist demographics, position characteristics, and pharmacy store characteristics. Logistic regression was performed to identify the risk factors associated with burnout. RESULTS: A total of 412 community pharmacists responded to the survey (7.4% response rate), of whom 411 were included in the final analysis. Overall, 308 (74.9%) of responding community pharmacists experienced burnout in at least 1 of the 3 subscales of the MBI-HSS. Most of the pharmacists experienced burnout owing to emotional exhaustion (68.9%), followed by depersonalization (50.4%) and reduced personal accomplishment (30.7%). The significant risk factors for burnout included shorter years of experience, practicing primarily in a chain pharmacy, and a lack of resources for burnout or resiliency. CONCLUSION: There is a high degree of burnout in community pharmacists (74.9%). Future research is warranted to examine optimal strategies to prevent burnout and promote resiliency in the profession.

Health Care Systems and Transitions of Care: Implication on Interdisciplinary Pharmacy Services.

Effective medication management is critical to successful patient outcomes. Pharmacists and pharmacy technicians working within North Carolina Health Systems provide a variety of services that aid in those successful outcomes. By leveraging the North Carolina Clinical Pharmacist Practitioner designation along with integrated health records, health system pharmacists are uniquely positioned to provide expert clinical support to patients. Services such as medication history collection, discharge medication dispensing and counseling, post discharge clinic engagement, and drug therapy management are all components of an even larger number of strategic health system pharmacy assets that aid in the care of patients whether they are admitted to hospitals, seen in clinics, or cared for in the community.

Digital content delivery in a pharmacy technician training program in a health system.

PURPOSE: Development and implementation of a pharmacy technician training program are described. SUMMARY: As key members of the healthcare team, pharmacy technicians are integral to a pharmacy's operation. Training programs allow technicians to assume roles that support pharmacists practicing "at the top of their license," assist in providing optimal patient care, and serve as an important tool for retaining trained pharmacy technicians. Duke University Health System (DUHS) launched its Pharmacy Technology Training Program (DUHS-PTTP) within the department of pharmacy at Duke University Hospital in April 2018 to assist in meeting current and future pharmacy technician demand. Candidates are provided with the tools to become certified pharmacy technicians through the completion of an affordable accredited program incorporating didactic, simulation-based, and experiential education. The program's partnership with a digital content provider enables accelerated start-up, minimizes investment in content creation and maintenance, enables automated record keeping, and provides flexibility for program participants to complete didactic content outside of the traditional classroom setting. Implementation of this program aims to support students both internal and external to the institution. Students are trained to begin a career as a pharmacy technician with the intent of producing graduates well equipped and eligible for certification by the Pharmacy Technician Certification Board. CONCLUSION: Implementation of a pharmacy technician training program is a logical extension of the demonstrated core training competency of health-system pharmacy departments.

Evidence of burnout in critical care pharmacists.

PURPOSE: Studies of critical care physicians and nursing personnel indicate a potentially high rate of burnout. To date there is a paucity of data in critical care pharmacists assessing burnout in this group. The purpose of this study was to assess the incidence of risk of burnout in critical care pharmacists. METHODS: Critical care pharmacists were solicited via email to complete an anonymous, electronic questionnaire regarding burnout. Subject demographic and employment characteristics were collected along with the validated, 22-item Maslach Burnout Inventory Health Services Survey in the study cohort. Burnout was assessed from 3 aspects, emotional exhaustion, depersonalization, and lack of personal accomplishment. High degree of burnout was defined as a score >27 in emotional exhaustion, or score >10 in depersonalization, or score <33 in personal achievement. Risk factors of burnout were evaluated using descriptive statistics and logistic regression. RESULTS: Out of 3,140 critical care pharmacists, 193 (6.1%) completed surveys. The mean scores were 25.3, 7.5, and 36.7 for emotional exhaustion, depersonalization, and reduced personal achievement, respectively. Overall, 123 pharmacists (64%) reported at least one syndrome of burnout, and 28 pharmacists (14.5%) reported burnout in all 3 scales. No single risk factor was identified to be associated with the risk of burnout. CONCLUSION: Risk of burnout is high in critical care pharmacists, at 64%, and is comparable to the risk in other critical care practitioner groups. This emphasizes the importance of continuing to evaluate risk factors for burnout and providing resources for burnout prevention to high-risk practitioners.

Evaluation of the Role and Impact of Ambulatory Clinical Pharmacists in an Academic Comprehensive Cancer Center.

INTRODUCTION: In recent years, there has been significant growth of ambulatory oncology pharmacy, yet there is a paucity of published studies on the clinical activities and impact of ambulatory oncology clinical pharmacists. At Duke Cancer Center, dedicated pharmacist services are embedded in specialized outpatient oncology areas. Pharmacists document their clinical and administrative activities in the electronic health record. The primary objective of this study is to quantify and assess ambulatory oncology pharmacist interventions in clinics in a large academic comprehensive cancer center. METHODS: For the purposes of this single-center, retrospective, descriptive study, pharmacist interventions were collected, quantified, and described over a 6-month period from July 1 to December 31, 2015. The study evaluated the perceived contribution and impact of a pharmacist on patient care in ambulatory oncology clinics via a survey that was distributed to providers and nurses. RESULTS: In the 6-month time period, there were 5,091 interventions spanning 3,967 patient encounters between nine ambulatory oncology clinic pharmacists. The average time per encounter in the 6-month time frame was 22.4 minutes. There were 92 respondents to the survey (61.7% response rate). Overall, responses showed that the clinical pharmacists add value to patient care and are integral members of the team. CONCLUSIONS: Although previous studies have described pharmacist activities in outpatient oncology clinics, this study showed a larger number and variety of clinical pharmacist activities in outpatient cancer clinics to improve patient care. Future directions include conducting prospective, controlled studies to link pharmacist activities to tangible outcomes.

Evidence of burnout in health-system pharmacists.

PURPOSE: Results of a study to determine levels of and risk factors for professional burnout among health-system pharmacists are reported. METHODS: The Maslach Burnout Inventory Human Services Survey (MBI-HSS) was distributed to a target population of health-system pharmacists to assess study participants for burnout, which is characterized by feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment. Health-system pharmacists were solicited via email through a professional network listserver to complete an anonymous, electronic questionnaire regarding burnout. Demographic information, employment characteristics, and responses to the MBI-HSS were collected using a cross-sectional cohort survey methodology. Descriptive statistics were used to assess MBI-HSS scores and risk factors associated with burnout. RESULTS: Of the 371 survey responses received, 329 were complete and included in the final analysis. Overall, 175 study participants (53.2%) reported scores indicating a high degree of burnout on at least 1 subscale of the MBI-HSS. Twenty-eight respondents (8.5%) had scores indicating burnout on all 3 subscales. Average scores were 22.9, 6.2, and 36.3 for feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment, respectively. Modifiable and nonmodifiable risk factors for burnout were identified. The findings warrant further research on burnout prevention and action to promote resilience in the profession. CONCLUSION: Half of health-system pharmacists assessed using the MBI-HSS in this study identified themselves as being at risk for burnout.

Coping with critical drug shortages: an ethical approach for allocating scarce resources in hospitals.

The number of critical medication shortages in the United States has reached an unprecedented level, requiring decisions about allocating limited drug supplies. Ad hoc decisions are susceptible to arbitrary judgments, revealing preformed biases for or against groups of people. Health care institutions lack standardized protocols for rationing scarce drugs. We describe the principles on which an ethically justifiable policy of medication allocation during critical shortages was created at our hospital. Based on supportable scientific evidence and with all clinically similar patients treated as similarly deserving of consideration, drugs were distributed according to a hierarchy of clinical need and predicted efficacy. We explain the ethical rationale for the procedures we adopted, how the policy was implemented at a large academic medical center, and more than 1 year of experience with a number of different medications. Our experience has demonstrated the feasibility and utility of formulating a rational and ethically sound policy for scarce resource allocation in an academic teaching hospital that could be used in a variety of health care settings. The method has proven to be reliable, workable, and acceptable to clinicians, staff, and patients.