Director-Purchaser Partnership

Director-Purchaser Partnership Lyle Matthews, Pharm.D., MAM Director, Pharmacy Services Eisenhower Medical Center

Goals • Offer Theories and Ideas • Stimulate Discussion • Support The Goals of the NPPA • Encourage Thoughts To Take Back Home

Disclaimers • One Director’s Thoughts (Mine) • Each Organization is Different • General Ideas And Philosophies • There Are Many Ways to Slice the Pie

Take-Aways • Staffing Model Options • Job Description Separation and Clarifying Importance of the Buyer Position – Focus on Regulatory Compliance • Salary Discussion • Management Team Membership • Director-Buyer Partnership

Here We Go • Questions: Pharmacy Buyers • Who Are You? • Why are You Important? • Why Should Organizations Care About the Pharmacy Buyer? • How Are You Perceived by Others?

Buyer’s Perspective On Things • “Nobody understands what I do?” • “Everyone has their hands in my inventory and messes it up.” • “Why do the other techs change my PAR levels when I’m gone?” • I have to do everything to make sure it is done right.”

Technician’s Perspective On Buyer Position? • “Anyone can do that job.” • “It is not that difficult.” • “I fill in for Him/Her all the time and it is easy.” • “Everyone knows how to place the order.” • “What does He/She do all day.”

Additional Staff Perspectives • “Why are we ‘always’ running out of things?” • “How come I can’t ever find anything?” • “How come we are ‘always’ changing generics for no reason?” • Etc., etc., etc.

How Do We Change It? • Job Description • Ok…Place the order, but what else? • Supervisory Responsibilities? • Financial Impact? • Clinical Impact? • Regulatory Compliance Impact? • Management Team Member

Supervisory Responsibilities? • Each Organization is Different, but… • I Suggest Not Having Any Supervisory Responsibilities • Pharmaceutical Purchasing is Too Important to the Organization to be Distracted From • Regulatory Compliance Partnership is Too Important to the Director

Importance of Buyer • Financial Impact • Has to be Celebrated, Publicized, Displayed, Shown off, etc. • Clinical Impact • Has to be Celebrated, Publicized, Displayed, Shown off, etc. • Regulatory Compliance Impact • Has to be Celebrated, Publicized, Displayed, Shown off, etc.

Financial Importance:Background and Perspective • Eisenhower Medical Center Financial Sign-Off Policy (common) • $1,000 – Director • $2,500 – V.P • $10,000 – C.O.O. • $25,000 – C.E.O

EMC Pharmacy Purchasing Statistics • $14,000,000 Annually • $1,167,000 Per Month • $38,350 Per Day (365 days) • $1,600 Per Hour • $27.00 Per Minute • $0.45 Per Second

Financial Impact • Contract Compliance • Physical Inventory Management • Carrying Costs and Inventory Turns • Minimizing Emergencies • Minimizing Waste and Expired Meds • Ongoing Analysis and Optimization

Clinical Impact • Arguably The Most Important Position In The Entire Pharmacy • Nobody Does Anything If There Are No Medications • Therapeutic Substitution Options • Safety • Working Through Shortages

Shortages – Are You Kidding? • Propofol • Heparin • Furosemide • Hydromorphone • Epinephrine • Naloxone • This is Nuts!!!

Regulatory Compliance • Recalls/Withdrawals • Storage Requirements • Automated Dispensing Cabinets • Controlled Substance Monitoring • Vaccines • Potential Citations and Fines from Regulators

Recalls/Withdrawals • How do We make Sure Everything Is Found? • Where Do We Keep The Records? • How Do We Segregate The Inventory? • Who’s Responsibility Is It?

Storage Requirements • Where are the medications? • Who put the Lorazepam injections in the automated dispensing cabinet? • Why is the Tisseel not in the freezer? • Who’s responsibility is it?

Automated Dispensing Cabinets • Who changed the PAR levels while I was gone? • Why are similar drugs located next to each other in the matrix drawer? • Who crammed the 100 Vicodin tablets in the single pocket? • Who’s responsibility is it?

Controlled Substance Monitoring • The single most important issue to the regulators and surveyors • FDA, DEA, Boards of Pharmacy, State Surveyors • Who has access? • Where are all the records kept? • Who’s responsibility is it?

Vaccines • The second most important issue to the regulators and surveyors • “Where are they stored? • “Prove to me they have been stored correctly.” • Who’s responsibility is it?

Partnering with The Director • Member of Management Team • Minimize Supervisory Tasks • Consistent one-on-one Meetings • Promote Position to the Organization • Communication Within the Pharmacy • Attend Budget Meetings

Salary Discussion • What is this position worth? • How does it fit into the overall department grid? • Create Expectations of Position • Create Separation from Staff Technicians • Create New Salary

Elevating The Buyer Position In The Organization • What Organizational Visibility Do You Have? • Do you Attend P&T? • Do You Meet With The Director and the Director’s Boss? • Do You Attend Nursing Meetings?

Elevating The Buyer Position In The Pharmacy • Are You On Staff Meeting Agendas? • Daily Purchasing Updates? • How Often Do You Meet With Other Managers? • Clinical • Operations • Informatics

Summary • Focus On Important Things You Bring To The Organization • Be Visible • Remember Regulatory Compliance • Separate Yourself From The Others • Think Outside The Pharmacy • Partner With Your Director

From One Director Thank You For All You Do Every Day

Questions?

Director-Purchaser Partnership