Outsourcing hospital pharmacy

[ethyl]

It seems a trend is catching on in hospitals in my area where multiple departments are getting outsourced to contract workers. Everything ranging from custodial, food workers, couriers, transport team, nursing, etc..

What have you heard of hospitals and their attempts on outsourcing their inpatient pharmacy in order to save money? Has anyone seen parts of a department contracted out or the majority of order entry sent to a central off-campus site?

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[confettiflyer]

I've seen carve outs where something like CPS runs the show, but not a full off site pharmacy.

 

[rxlea]

Interesting....do you know specific reasons why?

We've had some contact workers before but mostly during really busy times and it seemed limited to phlebotomists and techs.

 

[smercer]

It seems a trend is catching on in hospitals in my area where multiple departments are getting outsourced to contract workers. Everything ranging from custodial, food workers, couriers, transport team, nursing, etc..

What have you heard of hospitals and their attempts on outsourcing their inpatient pharmacy in order to save money? Has anyone seen parts of a department contracted out or the majority of order entry sent to a central off-campus site?

Our hospital contracted out Food and Nutrition services (though they left the Dietitians alone), Environmental Services, House Keeping/Laundry Services, and Pharmacy. Everything stayed the same in the Pharmacy, but we are now employeed by an out of state company in Texas. Now the other areas saw large layoffs and new hires during their transitions.

We also have a mix of Nurses that are full time hospital employees and some nurses that are temps from contracted out services.

The reason this is catching on is due to the fact that it creates set money for the hospital. The hospital no longer has to offer benefits to those employees of the contract services, as they are not actually hospital employees.

 

[Its Z]

Hospital does pay the salary and benefits. Its a pass through expense yet its a lumpsum instead of broken down.

Outsourcing depts is not new. And pharmacy outdourcing had been around since the 60s.

It makes sense to do it if the dept is inefficient. And if you have an effective manager there is no need for it.

I know all the tricks of outsourcing pharmacy business..worked with it for about 15 years. IMO Theres no need to outsource pharmacy today.

 

[Sparda29]

Our hospital pharmacy is going to start outsourcing TPN in a few weeks.

 

[rph3664]

Our hospital pharmacy is going to start outsourcing TPN in a few weeks.

That's very common in bigger facilities in large cities. Remember the TPN disaster in Birmingham, AL a couple years ago, where IIRC 9 people died from infections contracted through contaminated TPNs, which turned out to have been prepared in containers that had been rinsed with tap water? This. I realize that things almost never happen like this.

I've heard of pharmacy services being contracted out, although everyone still works onsite, for as long as I've been in the profession. Laundry and Food & Nutrition are commonly done this way too, as is the ER.

 

[xiphoid2010]

One of bigger hospital's near me out source the pharmacy department to cardinal. Their DOP is pretty cool guy, and we help each other out a lot. I heard when the hospital had their pharmacy inhouse, it was a mess, bad quality, CS issues, lost support from administration and other departments. Seems to be doing pretty good now.

We actually used to outsource TPNs before I came onboard, but there was a ton of problem getting the TPN order on time, sent right and getting it on time, not to mention we were getting charged a butt load for it. Thanks to switching to clinimix, that pretty much went away. But we still kept the contract alive just in case.

 

[rxgenmillennial]

What do you guys think about working for an outsourcing hospital pharmacy? good or bad?

 

[All4MyDaughter]

My employer has a contract to manage hospital pharmacy services for a large LTACH chain. The pharmacies are onsite but HR, and other management functions are run out of our corporate HQ. That part of the business is firewalled from our larger SNF/ALF pharmacy business.

 

[kvl1027]

Hospital does pay the salary and benefits. Its a pass through expense yet its a lumpsum instead of broken down.

Outsourcing depts is not new. And pharmacy outdourcing had been around since the 60s.

It makes sense to do it if the dept is inefficient. And if you have an effective manager there is no need for it.

I know all the tricks of outsourcing pharmacy business..worked with it for about 15 years. IMO Theres no need to outsource pharmacy today.

What's your opinion outsourcing certain practices like preparing CSPs? With all the regulation add-ons recently with steriles, it could seem beneficial from a regulatory compliance standpoint to let someone else be responsible. Maybe, maybe not, just wanted your expert opinion

 

[Dred Pirate]

I used to work as a director of pharmacy for a management company, Worked out great for me, I got a great position, great support.

 

[BidingMyTime]

I've worked in a couple of different hospitals where the hospital management was outsourced....the pharmacist & technicians worked directly for the hospital, but the pharmacy director was contracted through an outside organization (so was the hospital CEO & other management) I can't say I really noticed any difference in how they were run, compared to hospitals that did not contract management out. For all practical purposes, the managers worked as if they were employed by the hospital. Their "manager" (not sure that was the actual title) or representative from the contract place would come visit every so often (I guess to collect the money the hospital owed the contract company hahahahahahahaha) & check up on stuff.
I can't imagine that a completely contracted out pharmacy would be much different from any average hospital pharmacy. The contract company handles the pay & benefits, but the workload is still pretty much going to be the same.

 

[Its Z]

What's your opinion outsourcing certain practices like preparing CSPs? With all the regulation add-ons recently with steriles, it could seem beneficial from a regulatory compliance standpoint to let someone else be responsible. Maybe, maybe not, just wanted your expert opinion

Centers for Medicare/Medicaid Services (CMS) requires that contracted service must still abide by the quality standards of your facility based on your policy and procedures. So if your Compounded Sterile Product (CSP) preparation is outsourced to say...PharMedium/CAPS/Cantrell etc, they must still meet the quality standards set by your facility. And most facilities in the US use USP797/71 as guidelines in their compounding policy. That means if your low risk compounding requires potency and sterility testing to extend the expiration Beyond Use Date (BUD) of 48 hours out at room temperature, then the outsourced CSP company must follow your policy. This is much easier for them...since performing potency and sterility testing at a hospital based pharmacy/lab is not only laborius, it can be cost prohibitive.

 

[kvl1027]

Centers for Medicare/Medicaid Services (CMS) requires that contracted service must still abide by the quality standards of your facility based on your policy and procedures. So if your Compounded Sterile Product (CSP) preparation is outsourced to say...PharMedium/CAPS/Cantrell etc, they must still meet the quality standards set by your facility. And most facilities in the US use USP797/71 as guidelines in their compounding policy. That means if your low risk compounding requires potency and sterility testing to extend the expiration Beyond Use Date (BUD) of 48 hours out at room temperature, then the outsourced CSP company must follow your policy. This is much easier for them...since performing potency and sterility testing at a hospital based pharmacy/lab is not only laborius, it can be cost prohibitive.

That's my take. It could represent a significant cost savings and institutional pharmacies, however from a matter of scrutiny, they may try to limit outsourcing to FDA 503b facilities. Even though USP standards would be sufficient.