Table of Contents:
- The State of Pharmacy Burnout
- Burnout and Its Consequences
- Medication Shortages and Supply Chain Challenges
- USP 797 and Sterile Compounding Challenges
- Role of 503B Compounding Facilities
Hospital pharmacists have long been an unsung hero in healthcare, ensuring patients receive the right medications in a safe and timely manner. However, their role has become increasingly challenging in recent years, leading to a concerning rise in employee burnout. From increased demands placed on the role to stricter guidelines and disrupted supply chains, there is less and less time to focus on what’s most important - the health and safety of the patient.
First, let’s define burnout. Burnout is defined by the International Classification of Diseases 11th Revisions as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” Typically, burnout results in a decline in mental health, but it can also have physical manifestations. The side effects of experiencing burnout range from developing alcohol dependencies, depression, headaches, digestive problems, sleep disturbances, and weakened immune systems.
The State of Pharmacy Burnout
Pharmacist burnout and its effects are hot topics for industry studies. Many studies show that healthcare and pharmacy professionals are among the careers with the highest burnout rates. In a recent study published on PubMed, more than 51% of pharmacists are experiencing burnout. In a separate study, pharmacists were asked about their levels of burnout. According to the 2023 Pharmacy Times Burnout and Mental Health Survey, when pharmacists were asked to rate their feelings of burnout on a scale from 1 to 7, with 1 being “not at all” and 7 being “extremely,” the average score was 5.89. When asked how much they experienced burnout prior to the pandemic, however, the score was significantly lower at 3.82.
Burnout is an increasing effect of the growing responsibilities and ever-changing workplace environments among pharmacy professionals. While it’s not something that can be fixed overnight, 503b compounding facilities can help alleviate some of the causes of burnout and decrease the consequences that affect both pharmacy professionals and their patients.
Burnout and Its Consequences
Burnout among hospital pharmacists can have severe consequences for both the professionals and the patients they serve. High-stress levels, fatigue, and reduced job satisfaction can lead to medication errors and compromised patient safety. The Pharmacy Times Burnout and Mental Health Survey allowed respondents to submit their own symptoms of burnout. As mentioned earlier, these symptoms ranged from mental health issues like depression to physical symptoms such as headaches. See the graph below for more insights.
When asked to list the key drivers of burnout that cause these symptoms, workload was the top answer. The top 5 drivers were workload (21.7%), work/life balance (16.1%), challenging or unreasonable performance metrics (15.2%), management (14.3%), and high patient and prescription volumes (13.1%).
For many pharmacists, these workload changes include increased demands to follow strict protocols, prepare vaccinations, and perform sterile compounding. These additional responsibilities not only lead to employee burnout but also increase the potential of errors that can occur when providing patient care.
“Pharmacy burnout is a significant patient safety issue. It is impacting patients today with delayed prescription fulfillment, unacceptable waits for vaccines and testing, and potential errors due to high volume, long hours, and pressure to meet performance metrics,” the board of trustees of the American Pharmacists Association (APhA) said in December 2021, citing stress from the pandemic.
While many believe that the staffing issues are due to not having enough trained pharmacists, a Washington Post article reported that “organizations representing pharmacists counter that there is not a shortage of trained pharmacists.” Instead, the issue is that “there is a shortage of pharmacists and pharmacy technicians willing to work under the hothouse conditions at many retail pharmacies.” The rising number of pharmacy professionals experiencing burnout is a major factor in staffing shortages across the industry.
Medication Shortages and Supply Chain Challenges
Hospital pharmacists often face the daunting challenge of medication shortages, which have become increasingly common. These shortages require pharmacists to allocate scarce resources efficiently while maintaining patient care standards, adding to their workload and stress.
In our previous post, we discussed these shortages, the challenges they create, and how 503b partners provide solutions to combat drug shortages. One of the biggest takeaways is that these drug shortages put a lot of pressure on pharmacy professionals and their patients. While many suppliers are heavily impacted by shortages and logistical challenges, pharmacies tend to bear the brunt of the impact, including challenges in sourcing medications and managing inventory.
USP 797 and Sterile Compounding Challenges
Shifts in USP 797 guidelines are going to make the job harder, as the guidelines force hospitals and ASCs to focus on quality assurance, risk assessment, training, technology integrations, and overall regulatory compliance. These guidelines will become applicable on Nov. 1, 2023, and many people have questions. Over the summer at the NHIA/DC 23, industry professionals were able to present questions to four experts. These questions varied from broad considerations to very specific scenarios. Some of these questions were:
- When should we do a triple clean? When we do, how do we ensure the disinfectants are compatible?
- In a facility with an integrated vertical laminar flow zone with open architecture, two pharmacy teams share one large area. There are five tables for compounding; one team has two assigned to them and the other has three assigned to them. How should this facility move forward to comply with the USP revisions?
In addition to the rising concern about these guideline updates, many hospitals and pharmacies are experiencing higher rates of patient incidents due to compounding errors. Pharmacy Purchasing & Product Magazine reported that 27% of facilities across the country have reported experiencing a patient incident involving a compounding error over the past 5 years. They also noted that the frequency of these serious compounding errors rises along with compounding volumes.
When pharmacists are forced to carry the weight of additional regulatory measures, it not only takes away from their time helping patients but also increases their day-to-day responsibilities. And as we’ve learned, these workload increases are a major driver of pharmacist burnout. How do pharmacies and hospitals avoid these errors and employee burnout? Outsourcing and partnering with 503b facilities to get the highest quality, best regulatory risk reduction, and ensure great patient care.
Role of 503B Compounding Facilities
503B outsourcing facilities have emerged as a valuable resource to alleviate some of the compounding burden on hospital pharmacists. These facilities, regulated under the Drug Quality and Security Act (DQSA), specialize in large-scale, high-quality sterile compounding, providing hospitals with pre-made, sterile products that meet USP standards (Pharmacy Compounding Advisory Committee, 2020).
503b can offer solutions that not only save significant amounts of time and resources, and therefore alleviate burnout, but also help mitigate some of the potentially deadly results of burnout when considering patient safety.
- Avoid Burnout During Times of Uncertainty. Pharmacy Times Health-System Edition. Yamamoto, Kay. May, 2022.
- A systematic review and pooled prevalence of burnout in pharmacists. National Library of Medicine. Dee, Jodie. Dhuhaibawi, Nabaa. Hayden, John C. Nov 2022.
- Pharmacists Report High Levels of Burnout, Resulting in Understaffing and Alternative Career Paths. Pharmacy Times. Aislinn Antrim. April 2023.
- APhA: Pharmacist burnout hits breaking point, impacting patient safety. American Pharmacists Association. Press Release. December 2021.
- Pharmacists are burning out. Patients are feeling the effects. Washington Post. Kaufman, Marc. March 2023.
- Experts Tackle Key Questions as USP Go-Live Date Nears. Pharmacy Practice News. Shaw, Gina. May 2023.
- Regulatory Inspections. Pharmacy Purchasing & Products Magazine. April 2023.