Back in 2008, the American Society of Health-System Pharmacists (ASHP) developed a pandemic influenza assessment tool with the help of physicians, policy experts, healthcare executives, and the CDC. Earlier this year, they updated the tool to help pharmacists identify gaps in their preparation for the coronavirus pandemic.
The tool looks at six primary areas: integration of pharmacy preparations with institutional planning, departmental leadership, staffing, public and professional education and training, medications and supplies, and communications. The tool presents the key points as a checklist that pharmacies can use to check their progress.
The integration section focuses on the pharmacy’s preparation for the COVID-19 pandemic and whether that plan has incorporated best practices from other relevant plans. Then, it evaluates the extent to which the institutional plan includes pharmacy components, such as an infection-control plan, delivery of pharmaceutical services at alternative care sites, and continuity planning. Lastly, integration of the plan needs to go beyond the institution’s walls and reflect conversations with other local hospitals about interfacility communication during the pandemic.
The departmental leadership section covers straightforward matters regarding who is responsible for carrying out the pharmacy plan during a pandemic, who provides backup, and what responsibility each member of the team will assume.
The staffing questions cover the flip side of these items—contacting staff during an emergency, managing staff shortages and using nonhospital staff, working from alternative locations, prioritizing critical functions, and identifying the staff who will perform them. During a pandemic, developing a plan for monitoring staff for illness, determining when staff should stop work and when they can return to work, and communicating access to care and coverage are also essential.
To master the education and training components, the pharmacy needs to have a plan for bringing staff up to speed on key concepts of infection control in a pandemic—social distancing, use of personal protective equipment, prophylaxis, and treatment—as well as the specific features of COVID-19, such as transmissibility and the range of possible presentations.
Education of the public, both patients and visitors, on key control measures is critical as well. Training should cover incident command system training, backup training on critical workflow procedures, and emergency preparedness drills.
Central to the pharmacy preparation for the pandemic is an estimation of the need for medications, materials, and personal protective equipment for an 8-week pandemic with follow-on waves of 8 weeks and acquisition of those medications and supplies. Plans for monitoring stocks of critical materials and personal protection equipment are also essential. In addition, contingency plans for predicted or identified shortages should be developed, including use of alternative vendors and policies for reuse of respirators. The pharmacy plan should also incorporate a system for identifying and reporting outbreaks and adverse events related to the pandemic.
Communication encompasses coordination with internal and external groups as well as maintaining transparency with key stakeholders while providing a well-defined point of contact for the public. The pharmacy plan should include contact information for COVID-19 planning resources within the institution and in the community, such as public health, other hospitals, and state agencies. It should also address the need for the pharmacy to be linked to community surveillance initiatives.
