Esther Boadi, PharmD
In April 2023, the American Society of Health-System Pharmacists (ASHP) released survey results about pharmacy workforce well-being in the hospital setting. Pharmacy directors at 1,498 general and children’s medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. IQVIA supplied data on hospital characteristics and the survey sample was drawn from IQVIA’s hospital database. The response rate was 23.7%.
Pharmacist prescribing
The survey showed that inpatient pharmacists independently prescribed medications, including the selection, initiation, monitoring, and adjustment of medication therapy pursuant to a diagnosis in 27.1% of hospitals in 2022, compared to 30.9% of hospitals in 2021 and 21.1% of hospitals in 2020.
Data analytics
The survey results indicated that advanced analytics such as artificial intelligence, machine learning, and predictive analytics, are used in 8.7% of hospitals, an increase from 4.0% in 2021 and 2.6% in 2020.
While basic analytics, such as data from smart pumps, clinical decision support or automation in dispensing, and compound technology, are used in 84.7% of hospitals, the survey found that 6.6% of hospitals do not use any form of analytics.
Pharmacy service-level integration
Survey results show that 53.6% of hospitals report some integration of pharmacy services at all transitions of care, while 27.9% report that they are not at all integrated. However, 16.6% of hospitals consider themselves mostly integrated, an increase from 8.6% in 2021.
Advanced pharmacy technician activities
While traditional pharmacy technician activities such as purchasing, billing, and controlled substance management still predominate, more advanced roles are emerging. These advanced roles include regulatory compliance, 340B Drug Pricing Program management, responsibility for USP chapter <797> compliance, and initiation of medication reconciliation. Technicians have taken on many of these advanced roles since 2021.
Workforce well-being and shortages
Since the beginning of the pandemic, the entire workforce has been struggling with staff shortages, job training, job turnover, burnout, and overall employee well-being.
Survey results showed that various aspects of burnout are being seen in 34.0% of hospitals, while 83.7% of the hospitals surveyed are attempting to prevent and mitigate burnout.
Health-system pharmacies are experiencing workforce shortages; however, the survey results showed that these shortages have had limited impact on budgeted positions, with 62.8% of hospital pharmacy directors reporting that their budgeted pharmacist full-time employees (FTEs) remained the same.
The survey results indicate that 12.3% of pharmacy technician FTE positions are vacant. Additionally, 74.6% of hospitals reported inpatient pharmacy technician turnover, with a rate of 26.9%—an increase of 13.2% since 2014.
For pharmacists, 4.7% of FTE positions are vacant, with the overall rate of pharmacist turnover at 11%. In 2014, by contrast, the overall turnover rate was 6.8%.
The average number of full-time equivalents per 100 occupied beds is 16.9 for pharmacists and 16.1 for pharmacy technicians.
The survey authors concluded that adoption of practice advancement initiatives has continued the positive trend from past years despite workforce issues. The full survey results were published online on April 6, 2023, in the American Journal of Health-System Pharmacy. ■