One hundred forty four prescriptions filled in 7 days. That seems like a slow week at Novant Health Brunswick Medical Center. But those were the outpatient prescriptions, which the hospital doesn’t dispense normally.
The hospital in Bolivia, North Carolina, was hit hard by Hurricane Florence for 7 days in September 2018. Twenty-three inches of rain in Bolivia--and as much as 27 inches of rain in nearby Sunny Point--led to flooding and impassable roads. According to the National Weather Service, extensive wind damage caused thousands of downed trees and power outages throughout the eastern part of the state.
Pre-Hurricane Florence, Perry Allen, PharmD, pharmacy manager, a 26-year veteran at the hospital, had 2 priorities: Have the right team on scene before, during, and after the storm and secure the necessary medications to ride out the storm. Specifically, he ordered extra antibiotics, pain medications, and topical ointments and creams; the latter were required for treating patients injured by fallen trees.
Expected to impact the area for 3 days, the hurricane rendered roads impassable and flooding continued in many areas for a week. That’s why he worked with Novant Health’s logistics team to get additional medications from a tactical military convoy. The truck took a circuitous route from the hospital’s drug distributor in Virginia into South Carolina to avoid impassable roads to then head back to North Carolina. That’s where the military convoy was met by members of the Novant Health team who drove the medications and nursing supplies the final stretch to the hospital.
Dispensing outpatient prescriptions
Day 2 of Hurricane Florence, the local pharmacies were closed. That made sense, since electricity was out. It meant Allen’s team had to dispense outpatient prescriptions to patients who, otherwise, wouldn’t have their emergency medications. Ordinarily, the hospital doesn’t dispense prescriptions on an outpatient basis.
Allen had to ensure that the labels on the outpatient prescriptions included the information required by state and federal laws. In part, that information included the names of the patient and the prescribing physician, in addition to the name and quantity of the medication and guidance on taking the medication. Allen tapped his IT team to help cull that information and print it on the labels that were stuck on the prescriptions for patients who came to the hospital to receive them.
“That was a sticking point. How to do that. Develop a good-looking label so that patients would understand how to take [the medication],” said Allen.
Patients learned that the hospital was dispensing prescriptions through its network of physicians treating patients in local practices, said Allen. His team was also tasked with dispensing medications for employees who ran out of their emergency medications and people in neighboring areas who got stuck on the hospital campus during Hurricane Florence and its aftermath.
Since most patients were within the Novant Health network, Allen’s team could view their prescriptions, including dosage and directions for taking the medications, in the hospital’s computer system, said Allen. To fill a prescription for an opioid-based pain medication, a member of his pharmacy team spoke with the patient’s prescribing physician.
Leadership support essential
As part of the Novant Health network of 15 medical centers and more than 640 care locations, Allen’s team had access to logistics expertise. He credits 1 Novant Health employee, a former logistics expert in the US Army, with mapping out a safe route to transport the medications from the hospital’s drug distributor in Virginia and ensuring their arrival at the hospital’s campus.
Allen also lauded Shelbourn Stevens, the hospital’s president and chief operating officer, for clearing operational barriers. Hospital staff who worked through the storm had packed clothes for 3 days, but due to flooding and blocked roads, many couldn’t leave the hospital for a week. Hospital leadership responded by buying a washing machine and dryer for staff to clean their clothes, said Allen. In addition, the cafeteria was stocked with many options for meals for employees, patients, and people who became stranded at the hospital, he added.
Empowering employees to serve patients is what drove his approach during the hurricane, said Stevens. “That’s what comes first. It’s always the patient first....we try not to let normal operational things get in the way,” he added.
On behalf of the hospital’s pharmacy team, Allen received the 2019 American Society of Health-System Pharmacists (ASHP) CEO’s Award for Courageous Service.