Prospective inventory management systems for preempting problems related to medication unavailability

Over the past decade, drug shortages have evolved into a public health crisis, with continued growing evidence of negative effects on patient care.1,2 Despite multiple attempts to mitigate the drug shortage problem through legislation and other methods, there appears to be no potential end in sight to the drug shortage problem.3,4 As such, prospective management and preemption of any potential issues related to “just-in-time” inventory are imperative and remain ongoing needs. Thus, a prospective inventory management process is needed to alert and engage pharmacy staff to reduce the impact of this potential problem in pharmacy practice. Currently, our pharmacy staff services a 900-bed academic medical center through two central pharmacies, four operating-room satellite pharmacies, a critical care satellite pharmacy, and an oncology satellite pharmacy. This complex infrastructure requires focused management and the engagement of various members of the pharmacy staff in an effort to minimize the potential impact of drug shortages on pharmacy operations. A list of medications that are flagged as backordered by the manufacturer or wholesaler and their associated balance on hand in the pharmacy storeroom is compiled by the pharmacy technician purchaser and forwarded weekly to the pharmacy practice coordinators (PPCs). Responsibilities of the PPCs comprise scheduling, inventory management, and process improvement across various practice areas, including oncology, specialty pharmacy, acute care, operating rooms, and main operations. A list of potential items of concern (IOCs) is made based on drug utilization across the institution and forwarded from the PPCs to the advanced pharmacy practice experience administration student pharmacist. The student pharmacist is responsible for disseminating the list of potential IOCs to pharmacy technician specialists (i.e., lead technicians for specific pharmacy areas or locations), who must provide inventory information within 24 hours. Automated dispensing cabinets also play a vital role in assisting with this process, as electronic software allows our pharmacy team to keep a real-time count of all medications dispersed throughout the satellite pharmacies, inpatient floors, and outpatient clinics. The student pharmacist then generates and maintains a spreadsheet with the current total, previous total, and any pertinent notes for the potential IOCs.