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5 ways to tackle drug shortages

Publish Date: 10/24/2012

For hospitals, the national drug shortages are showing minimal impact, but for the ASCs they can be a nightmare. 

"Hospitals usually have a stronger purchasing network, and almost all hospitals have internal compounding pharmaceutical services so they can fractionate the drugs in-house rather than send them out like ASCs need to," explains Keith Metz, MD, anesthesiologist, medical director of Great Lakes Surgical Center in Southfield, Mich., and member of the ASC Association's board of directors.

The shortage is forcing ASCs to be creative with medication use and drug acquisition, says Sarah Martin, MBA, RN, CASC, vice president of operations for ASC management and development company Meridian Surgical Partners.

Metz and Martin suggest five ways for reducing the effect of drug shortages on ASC operations.

Step 1: Network with other ASCs in your area 

ASCs are typically good networkers, and the drug shortage presents an opportunity to ask peers for assistance.

"I think it's reasonable to call other ASCs in your area to see if someone has a larger supply of non-controlled substances then they anticipated and ask if they are willing to share with you," Metz states.

Networking can also help identify different vendors to contact.

"During a shortage of propofol, I emailed all Meridian centers and asked what vendors they reached out to for the drug," Martin explains. "I ended up with a list of different vendors to share."

Step 2: Partner with other ASCs for purchasing 

If your ASC has a good relationship with other surgery centers in the area, discuss creating a partnership for purchasing drugs, Metz advises. This will allow ASCs to place larger orders and, when They are fulfilled, have the drugs distributed to the network.

Step 3: Stay on top of your vendors 

If a vendor does not fulfill an order, the order may be cancelled.

"Initially we thought if you put in an order, you're in a queue," Martin says. "But with most vendors, you have to keep resubmitting the order because if you don't, you eventually fall out of the queue. If we normally order propofol twice a week, our centers will put in that order twice a week."

Step 4: Use alternative drugs 

If an ASC cannot acquire a drug but an appropriate alternative is available, such as substituting valium for versed, Martin says ASCs should consider the alternative.

"You just need to be aware of the potential side effects of alternatives," she explains. "Some alternatives may cause more nausea or require a longer recovery, for example. Make sure patients — as well as staff — are prepared for these side effects."

Step 5: Turn to compounding pharmacies 

ASCs can use compounding pharmacies to divide large bottles of drugs, such as propofol, into smaller, single-dose increments.

"That has previously been an acceptable methodology, but in the wake of the current steroid contamination at the Massachusetts compounding pharmacy, ASCs may be more reluctant to pursue that strategy," Metz says.

Resources 

Recommended Practices for Medication Safety 

Prepare for the Unexpected: Emergency Drugs and Protocols (free webinar recording)

Medication Safety: How Do You Measure Up? (free webinar recording)

 

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