Col. Carol W. Labadie MS USA is Pharmacy Program Manager and Pharmacy Consultant to the Army Surgeon General.
Pharmacy today is an exciting, challenging profession, and Army Pharmacy is no exception. Uniformed and civilian Army pharmacists and technicians provide world-class pharmaceutical care to our soldiers past and present and their families. The level of care and compassion is superb.
Last year, senior pharmacy leaders developed a strategic plan to guide Army Pharmacy and ensure success through the next 5-10 years. Leaders identified five strategic themes: building the pharmacy team; supporting global operational forces; maximizing the value of medications; balancing standardization with innovation; and telling the pharmacy story. This opportunity to “tell the pharmacy story” is one done with great pride.
Building the Team
Army Pharmacy is committed to recruiting quality pharmacists and technicians and retaining the best. Clinical and leadership skills are necessary to move forward with the understanding that senior leader mentoring, advanced training and practice improve knowledge and provide the confidence to perform at the highest levels. Post-graduate education programs such as Training with Industry, accredited informatics and administration pharmacy residencies, and advanced administration degrees are offered to mid-career pharmacists to improve leadership skills and enable them to assume jobs of increasing responsibility. However, the most successful story to date is the commitment to board-certify all military technicians. The Army Pharmacy staff at the AMEDD Center and School, Fort Sam Houston, TX, started the year 2010 by providing the opportunity for pharmacy technician students to voluntarily take the Pharmacy Technician Certification Board exam. To date, 95% of candidates have passed the exam, well above the national average of 76%.
Supporting Global Operational Forces
After 10 years of persistent conflict, pharmacists and technicians have continually volunteered to deploy to provide medication services to our warriors. Army Pharmacy currently deploys approximately 60 pharmacists and technicians annually. Their expertise is found in combat support hospitals, medical logistics units, divisions, and medical brigades. This could not be done without the willingness of our reserve pharmacists and technicians to mobilize and fill the vacancies left from these deployments. Reserve pharmacists and technicians mobilize, often multiple times, with minimum time between mobilizations. The dedication of these soldiers and their families is inspiring.
Maximizing the Value of Medications
Clinical pharmacists bring an additional level of medication care to the patient. Each Warrior in Transition Unit (WTU) has added a clinical pharmacist to the care team. Clinical pharmacists conducting comprehensive medication reviews on wounded warriors has improved medication compliance, reduced medication-related adverse events, and reduced risk of medication misuse and abuse. With successes come challenges and Army Pharmacy looks to these challenges as opportunities for improvement. While there has been great success with the wounded, ill, and injured in the WTUs, there are opportunities for improvement with the soldiers not in WTUs. Several recent studies have documented the increase in medication prescribing throughout the nation and the inherent risks with taking multiple medications. Clinical pharmacist interventions in the WTUs demonstrate that comprehensive medication reviews can reduce this risk. Army Pharmacy, even with limited resources, is embracing this opportunity and starting the process of communication and medication reviews with soldiers at risk.
Balancing Standardization with Innovation
Pharmacy automation and informatics are two of the most difficult challenges facing Army Pharmacy. Finding the right balance between automation and customer service is often difficult. People think that automation equals speed and efficiency. Pharmacy automation improves patient safety but frequently slows the processes of filling a prescription—not such a big deal when 100-200 prescriptions a day are filled, but a very big deal with the pharmacy filling 1,500-3,000 prescriptions a day. Pharmacy directors continually monitor workflow to maintain good customer service while ensuring patient safety. Pharmacy informatics systems are invaluable to the operation; however, lack of communication among several systems presents operational challenges. Redundancies and manual operations are necessary to overcome the current inconsistencies and are included in the strategic plan as areas of improvement.
The dedication of the Army Pharmacy team and the strategic vision of the pharmacy leaders press the advancement of military pharmacy. Collaboration and coordination with federal pharmacist partners provide the opportunity to advance the pharmacy profession even further.