Director-Purchaser Director-Purchaser PartnershipPartnership

Lyle Matthews, Pharm.D., MAMLyle Matthews, Pharm.D., MAM

Director, Pharmacy ServicesDirector, Pharmacy Services

Eisenhower Medical CenterEisenhower Medical Center

GoalsGoals

Offer Theories and IdeasOffer Theories and Ideas

Stimulate DiscussionStimulate Discussion

Support The Goals of the NPPASupport The Goals of the NPPA

Encourage Thoughts To Take Encourage Thoughts To Take Back HomeBack Home

DisclaimersDisclaimers

One Director’s Thoughts (Mine)One Director’s Thoughts (Mine)

Each Organization is DifferentEach Organization is Different

GeneralGeneral Ideas And Philosophies Ideas And Philosophies

There Are Many Ways to Slice the There Are Many Ways to Slice the PiePie

Take-AwaysTake-Aways

Staffing Model OptionsStaffing Model Options

Job Description Separation and Job Description Separation and Clarifying Importance of the Buyer Clarifying Importance of the Buyer Position – Focus on Regulatory Position – Focus on Regulatory ComplianceCompliance

Salary DiscussionSalary Discussion

Management Team MembershipManagement Team Membership

Director-Buyer PartnershipDirector-Buyer Partnership

Here We GoHere We Go

Questions: Pharmacy BuyersQuestions: Pharmacy Buyers

– Who Are You?Who Are You?

– Why are You Important?Why are You Important?

– Why Should Organizations Care Why Should Organizations Care About the Pharmacy Buyer?About the Pharmacy Buyer?

– How Are You Perceived by How Are You Perceived by Others?Others?

Buyer’s Perspective On ThingsBuyer’s Perspective On Things

““Nobody understands what I do?”Nobody understands what I do?”

““Everyone has their hands in my Everyone has their hands in my inventory and messes it up.”inventory and messes it up.”

““Why do the other techs change my Why do the other techs change my PAR levels when I’m gone?”PAR levels when I’m gone?”

I have to do everything to make sure I have to do everything to make sure it is done right.”it is done right.”

Technician’s Perspective On Buyer Technician’s Perspective On Buyer Position?Position?

““Anyone can do that job.”Anyone can do that job.”

““It is not that difficult.”It is not that difficult.”

““I fill in for Him/Her all the time and it I fill in for Him/Her all the time and it is easy.”is easy.”

““Everyone knows how to place the Everyone knows how to place the order.”order.”

““What does He/She do all day.”What does He/She do all day.”

Additional Staff PerspectivesAdditional Staff Perspectives

““Why are we ‘always’ running out of Why are we ‘always’ running out of things?”things?”

““How come I can’t ever find How come I can’t ever find anything?”anything?”

““How come we are ‘always’ changing How come we are ‘always’ changing generics for no reason?”generics for no reason?”

Etc., etc., etc.Etc., etc., etc.

Operations

Technicians

Resp. TherapyRadiology

RegulatoryCompliance

Informatics(Bar-Coding)

Clinical Pharmacists

Administration

Buyer

How Do We Change It?How Do We Change It?

Job DescriptionJob Description Ok…Place the order, but what else?Ok…Place the order, but what else? Supervisory Responsibilities?Supervisory Responsibilities? Financial Impact?Financial Impact? Clinical Impact?Clinical Impact? Regulatory Compliance Impact?Regulatory Compliance Impact? Management Team MemberManagement Team Member

Supervisory Responsibilities?Supervisory Responsibilities?

Each Organization is Different, but…Each Organization is Different, but…I Suggest Not Having Any I Suggest Not Having Any Supervisory ResponsibilitiesSupervisory ResponsibilitiesPharmaceutical Purchasing is Too Pharmaceutical Purchasing is Too Important to the Organization to be Important to the Organization to be Distracted FromDistracted FromRegulatory Compliance Partnership is Regulatory Compliance Partnership is Too Important to the DirectorToo Important to the Director

Importance of BuyerImportance of Buyer

Financial ImpactFinancial Impact– Has to be Celebrated, Publicized, Displayed, Has to be Celebrated, Publicized, Displayed,

Shown off, etc.Shown off, etc.

Clinical ImpactClinical Impact– Has to be Celebrated, Publicized, Displayed, Has to be Celebrated, Publicized, Displayed,

Shown off, etc.Shown off, etc.

Regulatory Compliance ImpactRegulatory Compliance Impact– Has to be Celebrated, Publicized, Displayed, Has to be Celebrated, Publicized, Displayed,

Shown off, etc.Shown off, etc.

Financial Importance:Financial Importance:Background and PerspectiveBackground and Perspective

Eisenhower Medical Center Eisenhower Medical Center Financial Sign-Off Policy (common)Financial Sign-Off Policy (common)

$1,000 – Director$1,000 – Director$2,500 – V.P$2,500 – V.P$10,000 – C.O.O.$10,000 – C.O.O.$25,000 – C.E.O$25,000 – C.E.O

EMC Pharmacy EMC Pharmacy Purchasing StatisticsPurchasing Statistics

$14,000,000 Annually$14,000,000 Annually

$1,167,000 Per Month$1,167,000 Per Month

$38,350 Per Day (365 days)$38,350 Per Day (365 days)

$1,600 Per Hour$1,600 Per Hour

$27.00 Per Minute$27.00 Per Minute

$0.45 Per Second$0.45 Per Second

Financial ImpactFinancial Impact

Contract ComplianceContract Compliance

Physical Inventory ManagementPhysical Inventory Management

Carrying Costs and Inventory TurnsCarrying Costs and Inventory Turns

Minimizing EmergenciesMinimizing Emergencies

Minimizing Waste and Expired MedsMinimizing Waste and Expired Meds

Ongoing Analysis and OptimizationOngoing Analysis and Optimization

Clinical ImpactClinical Impact

Arguably The Most Important Position Arguably The Most Important Position In The Entire PharmacyIn The Entire Pharmacy

Nobody Does Anything If There Are Nobody Does Anything If There Are No MedicationsNo Medications

Therapeutic Substitution OptionsTherapeutic Substitution Options

SafetySafety

Working Through ShortagesWorking Through Shortages

Shortages – Are You Kidding?Shortages – Are You Kidding?

PropofolPropofolHeparinHeparinFurosemideFurosemideHydromorphoneHydromorphoneEpinephrineEpinephrineNaloxoneNaloxoneThis is Nuts!!!This is Nuts!!!

Regulatory ComplianceRegulatory Compliance

Recalls/WithdrawalsRecalls/Withdrawals

Storage RequirementsStorage Requirements

Automated Dispensing CabinetsAutomated Dispensing Cabinets

Controlled Substance MonitoringControlled Substance Monitoring

VaccinesVaccines

Potential Citations and Fines from Potential Citations and Fines from RegulatorsRegulators

Recalls/WithdrawalsRecalls/Withdrawals

How do We make Sure Everything Is How do We make Sure Everything Is Found?Found?

Where Do We Keep The Records?Where Do We Keep The Records?

How Do We Segregate The How Do We Segregate The Inventory?Inventory?

Who’s Responsibility Is It?Who’s Responsibility Is It?

Storage RequirementsStorage Requirements

Where are the medications?Where are the medications?

Who put the Lorazepam injections in Who put the Lorazepam injections in the automated dispensing cabinet?the automated dispensing cabinet?

Why is the Tisseel not in the freezer?Why is the Tisseel not in the freezer?

Who’s responsibility is it?Who’s responsibility is it?

Automated Dispensing CabinetsAutomated Dispensing Cabinets

Who changed the PAR levels while I Who changed the PAR levels while I was gone?was gone?

Why are similar drugs located next to Why are similar drugs located next to each other in the matrix drawer?each other in the matrix drawer?

Who crammed the 100 Vicodin Who crammed the 100 Vicodin tablets in the single pocket?tablets in the single pocket?

Who’s responsibility is it?Who’s responsibility is it?

Controlled Substance Controlled Substance MonitoringMonitoring

The single most important issue to The single most important issue to the regulators and surveyorsthe regulators and surveyors

FDA, DEA, Boards of Pharmacy, FDA, DEA, Boards of Pharmacy, State SurveyorsState Surveyors

Who has access?Who has access?

Where are all the records kept?Where are all the records kept?

Who’s responsibility is it?Who’s responsibility is it?

VaccinesVaccines

The second most important issue to The second most important issue to the regulators and surveyorsthe regulators and surveyors

““Where are they stored?Where are they stored?

““Prove to me they have been stored Prove to me they have been stored correctly.”correctly.”

Who’s responsibility is it? Who’s responsibility is it?

Partnering with The DirectorPartnering with The Director

Member of Management TeamMember of Management Team

Minimize Supervisory TasksMinimize Supervisory Tasks

Consistent one-on-one MeetingsConsistent one-on-one Meetings

Promote Position to the OrganizationPromote Position to the Organization

Communication Within the PharmacyCommunication Within the Pharmacy

Attend Budget MeetingsAttend Budget Meetings

Salary DiscussionSalary Discussion

What is this position worth?What is this position worth?

How does it fit into the overall How does it fit into the overall department grid?department grid?

Create Expectations of PositionCreate Expectations of Position

Create Separation from Staff Create Separation from Staff TechniciansTechnicians

Create New SalaryCreate New Salary

Elevating The Buyer Position In Elevating The Buyer Position In The OrganizationThe Organization

What Organizational Visibility Do You What Organizational Visibility Do You Have?Have?

Do you Attend P&T?Do you Attend P&T?

Do You Meet With The Director and Do You Meet With The Director and the Director’s Boss?the Director’s Boss?

Do You Attend Nursing Meetings?Do You Attend Nursing Meetings?

Elevating The Buyer Position In Elevating The Buyer Position In The PharmacyThe Pharmacy

Are You On Staff Meeting Agendas?Are You On Staff Meeting Agendas?

Daily Purchasing Updates?Daily Purchasing Updates?

How Often Do You Meet With Other How Often Do You Meet With Other Managers?Managers?– ClinicalClinical

– OperationsOperations

– InformaticsInformatics

SummarySummary

Focus On Important Things You Bring Focus On Important Things You Bring To The OrganizationTo The Organization

Be VisibleBe Visible

Remember Regulatory ComplianceRemember Regulatory Compliance

Separate Yourself From The OthersSeparate Yourself From The Others

Think Outside The PharmacyThink Outside The Pharmacy

Partner With Your DirectorPartner With Your Director

From One DirectorFrom One Director

Thank You For All You Thank You For All You Do Every DayDo Every Day

Questions?Questions?