How A Director Of Pharmacy Has Been Managing The COVID-19 Pandemic
An Interview With Rogers Elebra, PharmD.
Recorded August 28, 2020
What Is Your Name And Job Title?
My name is Rogers Elebra and I am currently the pharmacy director at Surgeons Choice Medical Center in Southfield, Michigan, and also a team member of Indispensable Health.What Is Your Role With Indispensable Health?
I am part of the Pharmacy Management team.How Has COVID-19 Impacted Your Pharmacy?
Seeing as my operations are primarily inpatient pharmacy it has drastically impacted our operations from the standpoint of managing the shortages, drug shortages that’s a big component of our continued daily struggle. At the same time business activity has really slowed down. Obviously COVID-19 has impacted hospital operations as a whole, and in turn, has trickled down to the various departments. We don’t have that many patients in-house, don’t get the chance to do a lot of what you do on a typical day. So those are some concerns, and of course, that drags onto the human resources as well - staffing concerns and how to manage that. It’s a continuous balancing act with that impact of not having enough, how you can’t do too much, not exceeding budgets, and things like that because all of the budgets have been severely constrained.What Has Been The Hardest Part Of Your Job Throughout The Pandemic?
The unknown. We still have a lot of unanswered questions, a lot of unknowns, and not knowing what the future holds in terms of daily operations and the solvency of the hospitals in which we are working in. So that has been mainly the biggest concern in the back of our minds. At the end of the day, we still have to provide the best patient care we can provide to our patients, as they still rely on us to do what we do. That’s more of a mental issue in terms of managing that and ensuring you have a clear mind to still forge ahead, lead, and do your job to the best of your ability. That’s the most important thing in terms of dealing with the struggles.Besides that, it’s really just keeping up with the supply chain issues. We do need medications, especially because we’re the hospital’s pharmacy, to provide those medications in order for the rest of the hospital medical team to provide care to the patients that come in. They rely on us so we have to be really resourceful in ensuring that we keep on top of what market happenings are and being very resourceful to alternatives if primary products end up being unavailable, and what to do next - planning ahead essentially.
Has Anything Surprised You Along The Way?
I consider pharmacy all to be very dynamic and things happen really fast, things happen on a day-to-day basis, one day is never the same as the next. So for me personally, I don’t look at things as surprises I look at them as dynamic changes. You have to expect that not everything is going to be status-quo and to be on the ready to adapt to these changes.If You Knew What You Knew Now, Before The Pandemic Began, Is There Anything You Would Have Done Differently?
Interesting. Interesting, because this is something that no one really planned for, it was totally unexpected, came out of left-field, no one saw it coming, and rapid adjustments had to be made. Perhaps one key area that one can go after, after going through this experience - and still going through this experience - is having in place better or more robust mitigation strategies for the global type of events that could be very disruptive.In the past, we’ve typically planned for the regular medication, a particular product, or the supply of stuff will be back-ordered but we get a heads up most of the time to anticipate ahead of time what we are going to do in terms of changing manufactures, looking for alternative sources, looking for alternative therapeutic regimens, and things that you can do clinically. For something like COVID-19, it’s beyond that. It’s like okay this is global. What do you do in this kind of situation, or how can you plan for this kind of situation? I wouldn’t go as far as saying we should have our own stockpile, but I guess one has to start thinking about the impact of not just local events but also a global event. Our supply chain is global, that’s what everyone knows now. We rely a lot on materials coming from far away so what do you do when you can’t get it? So I think that will be one big area moving forward from the planning perspective is emergency preparedness. I think that’s what is happening, or should be happening, in conversations at least, with all institutions and healthcare primarily. That’s our focus at Surgeons Choice.
Has This Changed How You View Your Role As A Pharmacy Leader?
Yes, because now there’s more involvement from a pharmacy standpoint and especially because this pandemic is a health-related issue our role as part of the healthcare team, an integral part of the healthcare team, is more highlighted. Fellow healthcare professionals look at us now to say, “this is where we are at with therapies, where do you come in or where can you help us to ensure that we can still provide the necessary care to our patients”? It is very clearly evident that this is my responsibility as a pharmacy leader to ensure that I am that valuable resource, and it is brought to the forefront now. It’s in our daily conversations now, because what we do impacts the ability of the other healthcare team members, especially from a nursing standpoint in terms of administration of medications, and from a physician standpoint in terms of ordering therapies for the respective patients. Pharmacists have always been in the middle but we have probably garnered more appreciation now.How Has Your Pharmacy Team Been Affected By The Pandemic?
One of the huge aspects has been in a shortage of hours, which has been a primary concern for them. As I indicated, in the beginning, is that as the pandemic continues, and it definitely has impacted hospital operations, that means it has impacted the hospital’s bottom lines as well. We have lower than expected capacity, in terms of patients that we have to provide care for, and we have to manage our resources. We have to cut back on the hours, make some adjustments in staffing, and still try to be efficient and not laps up in the care we provide. The expectation is, no matter what, pharmacy is still going to deliver. That has been a major thing, in terms of cutting back the hours, and at the on-set of the pandemic laying off some of the staff - or putting them on furlough.How Did You Cope With Delivering Layoff News To Some Of Your Team?
Being the lead, my role has been to have the conversation, be transparent, and be real about the situation. I think it has been great, at least with my team, that we have very frank, open, conversations regarding daily operations and how important each person’s role is in what we do. Of course, also sharing information with my team and listening to input from them as well regarding the direction we go.The decisions that we have made have been more collaborative, not necessarily authoritarian, or one-directional. I have been pleasantly surprised as well at some of the things that my team has responded to, or have been willing to sacrifice just to ensure that things go the way that we anticipate things to go for the hopefully short term. They’re in good spirits, and it is very important that the mental health aspect of this whole ordeal is in good accordance as well. We ensure that we factor that in, having time off to just reset yourself, to spend more time with family, and just ensuring that there is flexibility as well.
What Can We Do Now To Prepare Our Pharmacy Teams For Changes Of This Magnitude?
I don’t think there’s really any playbook out there to prepare for something like this. Again, COVID-19 is unprecedented, I think the key lesson here is the importance of adaptability. We have to be quite nimble in how we operate, or go about our business, understanding that change really impacts our day-to-day operations. Just being aware, and not taking things for granted in terms of what happens today will be what happens into the future. Adaptability is a key factor with us.What Was The Most Effective Change You Implemented During The Pandemic?
There is better communication internally and externally to other members of the healthcare team that we collaborate with and support. Now, more than ever, the drum is beating louder that we need to work together. Basically it is a team effort and the COVID-19 pandemic has definitely shined a light on that concept. Also, really managing the resources. With what is happening now, and when pharmacy expresses concern regarding waste or realization of a particular medication or therapy agent, and brings up issues of cost and difficulty in sourcing that product for future patients, I think the listening ear is tugged a little bit closer. As opposed to some providers just saying, “I want what I want”. I think now, it is very resounding that they listen more intently and they go, “you’re right”, let’s stretch the resources as well as we can, let’s look for alternative sources, or whatever the case may be.Do You Believe Any Of The Changes You Have Made Will Continue Post-pandemic?
I would think so! These changes are considered positive changes, in my opinion, and I think this will continue. It’s been a very eye-opening experience for everyone that really we are all interconnected in terms of providing care. So, if we want to continue to provide great care, we can see what we are going through now as a good test, that if we work together we get the best results and outcomes.What Would You Recommend To Other Pharmacy Managers For The Challenges That Lay Ahead?
I think a valuable lesson in this whole experience, as we continue to plug through this, is the importance of collaboration. That entails both communicating effectively to team members as well as other participants on the healthcare team, but also being resourceful. Pharmacy sees issues, or problems, and we try to resolve them. We are the problem solvers in healthcare, that’s my impression, and I think the rest of the healthcare team relies on us to come through. We may not necessarily have all the answers, or have what everyone else is asking of us, but I think the approach in which we address those concerns is valuable. I think that’s key in gaining the relevance pharmacy is looking for.To Wrap Up, How Have You Been Doing Through The Pandemic?
Well, I’ve been great. For me I have always been a positive person. I’ve not been too hard on myself, or down on myself, but have been very understanding. First of all I’ve also been very fortunate that so far I have been healthy and I think that has been my biggest concern, as well as my ability to continue to do my job. I have also been able to take care of my family, and the people around me. Once I know that is all set it’s just a matter of taking on the world, if you will, the best way I can and working collaboratively with everyone. So I’m in good spirits, and I try to influence others to have that same outlook. I think the more of us that put a positive outlook on things, the more we have a clearer mind to do the right things to bring about the right kind of changes we want as well.
