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April 4, 2019

 

Over the past two years, Jordan Long, Pharm.D. ’17 served at Cleveland Clinic, a world renowned leading hospital in healthcare. Its pharmacy prides itself in being a leader in pharmacy practice and healthcare innovation.

Health-System Integration
As Cleveland Clinic continues to grow, now with twelve hospitals in Northeast Ohio, five in Florida and two internationally, the need for integration becomes vital to continued success and potential growth. The department of pharmacy continues to assess areas to integrate and standardize practice across the system. An important step in this direction is clear pharmacy leadership that oversees the strategic plan and operations of the pharmacy enterprise. All pharmacy system directors and hospital directors report directly to Scott Knoer, the Cleveland Clinic’s Chief Pharmacy Officer. He provides clear direction to all of his direct reports and ensures there is a clear strategic plan for the department of pharmacy. To help further integrate the system, a Director of Integration helps support standardization and communication across all of its hospitals. Integration is ensured through system-wide operations and clinical integration committees, a pharmaceutical and therapeutics (P&T) committee is established at each hospital which collaborate through a system-wide P&T committee, and monthly director of pharmacy meetings serve to bring system leadership together. Jordan remarked, “When working with so many different hospitals, having clear, direct communication is important for ensuring understanding. My current involvement on the Enterprise Operations Committee involves developing, articulating, and communicating minutes for each meeting. This allows for each member of the committee to understand the conversation and deliverables for each topic of discussion.”

Drug Shortages
Jordan continue to witness the tireless demands that drug shortages have on a health-system enterprise. In some cases, these shortages may never affect a hospital – whether the hospital does not have the shorted product on formulary, their days on hand supply is sufficient to weather the shortage, or the hospital has a diverse supply chain portfolio that allows them to procure the product elsewhere. “Cleveland Clinic uses a lot of medications to help support its patient population. The 2019 drug budget is over $1 billion and the forecast is for it to continue to increase due to inflation, higher utilization of specialty pharmacy services, and rising drug costs,” states Jordan. “I have seen how utilization of a large volume of medications and having a more robust formulary with limited days on-hand supply of commonly used items, can lead to the need for a diverse portfolio. Hurricane Maria in 2017 helped me realize there are opportunities for improvement in these areas.” Jordan has the opportunity to work with a drug shortage pharmacist, a very unique pharmacist who projects and manage shortages so that these shortages are not felt outside the department of pharmacy. As a resident, he has been involved in new contracting strategies, inventory management, and understanding the pedigree of their product. “Who would have known that most of the products that our hospital purchased came from Puerto Rico, a small island that sits right in the middle of a hurricane alley? Having this better understanding and utilizing the volume that we have allows us to better manage these issues when they arise in the future. We are also currently investigating the addition of a 503b facility at Cleveland Clinic, which would allow us to compound medications that could be sent to all the hospitals in our enterprise,” commented Jordan.

Innovation
“In our pharmacy,” Jordan continues, “We utilize two different technologies that were homegrown, one of which controls our carousel technology and one that tracks our medication preparation and delivery process. Both softwares were originally built and tested at Cleveland Clinic pharmacy, allowing us to help build something to fit our department’s needs. Another innovation is our IV compounding areas. In our main pharmacy, you will find an IV room with no hoods and a 60 foot wall where our technicians’ compound under a plexiglass wall that funnels clean filtered air into the compounding area. At the end of the wall, you will find a large IV compounding robot, one of the four that are currently running at main campus. In research, we are constantly looking at new ways to approach outcomes, productivity, and big data. As healthcare continues to change and adapt, so must pharmacy practice to help meet the needs of our health-systems.”

“I am very excited to continue working at the Cleveland Clinic and always look forward to new ways we will integrate, manage challenges we face, and look to innovate new technology and practice models to shape our profession for greatest impact on tomorrow’s healthcare.”

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