The high-value pharmacy enterprise framework: Advancing pharmacy practice in health systems through a consensus-based, strategic approach.

PURPOSE: The high-value pharmacy enterprise (HVPE) framework and constituent best practice consensus statements are presented, and the methods used to develop the framework's 8 domains are described. SUMMARY: A panel of pharmacy leaders used an evidence- and expert opinion-based approach to define core and aspirational elements of practice that should be established within contemporary health-system pharmacy enterprises by calendar year 2025. Eight domains of an HVPE were identified: Patient Care Services; Business Services; Ambulatory and Specialty Pharmacy Services; Inpatient Operations; Safety and Quality; Pharmacy Workforce; Information Technology, Data, and Information Management; and Leadership. Phase 1 of the project consisted of the development of draft practice statements, performance elements, and supporting evidence for each domain by panelists, followed by a phase 2 in-person meeting for review and development of consensus for statements and performance elements in each domain. During phase 3, the project cochairs and panelists finalized the domain drafts and incorporated them into a full technical report and this summary report. CONCLUSION: The HVPE framework is a strategic roadmap to advance pharmacy practice by ensuring safe, effective, and patient-centered medication management and business practices throughout the health-system pharmacy enterprise. Grounded in evidence and expert recommendations, the statements and associated performance elements can be used to identify strategic priorities to improve patient outcomes and add value within health systems.

Assessment of technician barcode scanning verification compared to pharmacist verification.

PURPOSE: This study aims to show the feasibility and sustainability of technician barcode scanning verification as an alternative to pharmacist visual verification of first dose medications in an acute care setting. METHODS: A two-phase, noninferiority, single-center study was conducted to compare the accuracy of technician barcode scanning verification to pharmacist visual verification of pre-packaged first dose medications within a large acute care medical center. In phase 1, a pharmacy technician utilized barcode scanning as a means of verification. These preparations were then re-verified for accuracy by pharmacist visual verification. In phase 2, the verification order was reversed, starting with pharmacist visual verification of first doses, which were subsequently re-verified by a technician utilizing barcode scanning. Accuracy and efficiency (first dose processing time) of each phase was analyzed via error logs and retrospective dose tracking. RESULTS: A total of 12,328 first dose preparations were included in the analysis and showed no difference between technician barcode scanning verification and pharmacist visual verification. Retrospective time study showed a 4-minute decrease in processing time when doses were verified by technician barcode scanning. Based on initial study outcomes, a variance was granted to pilot first dose tech-check-tech by the Wisconsin State Board of Pharmacy. CONCLUSION: This study determined that there is no difference in verification accuracy between technician barcode scanning verification and pharmacist visual verification of first doses in an acute care setting. Through leveraging technology and skill mix, Froedtert Hospital was able to provide the same level of patient safety while decreasing pharmacy processing time, developing our technician workforce, and reallocating pharmacist staff from distributive roles in central pharmacy to decentralized clinical activities.