Becker's Hospital Review

25 PHARMACY The pharmacy strategy that helped avoid 512 drug stockouts By Ella Jeffries F or Andrea Jarzyniecki, PharmD, director of pharmacy at omasville, Ga.-based Archbold Medical Center, a platform- based approach to medication management has led to measurable results: $1.9 million in avoided waste, 512 stockouts avoided and a 20% reduction in technician inventory labor. e gains come as drug shortages continue to strain hospital operations — and as the U.S. Pharmacopeia flagged 100 vulnerable drugs in the U.S. supply chain, highlighting upstream risks such as reliance on single-country manufacturing and the complexity of injectable products. But for Dr. Jarzyniecki, external signals such as the USP list are useful only to a point. "What difference is it going to make if I don't know what's going on in my own house?" she said. Shortages, she added, are no longer occasional disruptions — they are a constant part of pharmacy operations. Fieen years ago, systems might have managed one or two shortages at a time. Today, they are navigating dozens simultaneously, oen with dedicated staff tracking supply issues across the week. "Strategically navigating shortages has become much more endemic to our practice over the last decade," Dr. Jarzyniecki said, noting that even smaller systems can spend 20 or more hours a week chasing shortages. At the same time, traditional inventory strategies have become harder to sustain. Long-standing reliance on "just-in-time" inventory and tight inventory turnarounds — once standard performance benchmarks — has clashed with an environment in which supply is far less predictable. "You usually got what you ordered," she said of earlier years. "at wasn't really a problem." Now, the bigger issue is visibility. For many health systems, inventory is spread across dozens or even hundreds of locations, and data is fragmented across dispensing systems, purchasing records and spreadsheets. At Archbold, a single medication can exist in nearly 100 different locations across the system, she said. Historically, that meant pharmacy teams were working off static reports, trying to interpret utilization patterns aer the fact. "I've looked at thousands upon thousands of rows of utilization," Dr. Jarzyniecki said. But that process relied on imagining how inventory moved, rather than seeing it in real time. To close that gap, Archbold shied to a platform-based approach to medication management, combining real-time inventory visibility with a centralized shortage management tool. e result has been a move away from reactive decision-making toward more proactive control over inventory and supply. e change has also reduced the operational burden of managing shortages. Administrative teams that once spent hours each week discussing supply issues now spend just minutes. "e amount of time our administrative team spends on shortages a week is probably less than 10 minutes," Dr. Jarzyniecki said, down from one to two hours of weekly meetings alone. At the same time, the system has rethought how it approaches inventory. Rather than minimizing stock to meet traditional benchmarks, Archbold has built intentional "safety stock" for high- risk medications — particularly generic sterile injectables, which are more prone to prolonged shortages. Instead of spreading inventory thin across hundreds of items, the system also focuses on maintaining stronger reserves for 50 to 70 critical drugs. Dr. Jarzyniecki credits the success to a combination of better purchasing decisions, reduced waste and fewer last-minute substitutions. e financial trade-off is oen misunderstood, she said. Holding more inventory may increase carrying costs, but it can prevent more expensive outcomes, such as having to purchase higher-cost alternatives during a shortage. In some cases, a system could let a lower-cost generic drug expire multiple times and still spend less than it would switching to a brand-name alternative during a supply disruption. Greater visibility has also allowed the system to move inventory more strategically across sites. For example, high-cost, low-use medications can be stocked at smaller hospitals to expand access, then transferred to higher-volume locations before they expire. "at's made me able to say yes more to broader access to medications and care," she said. e approach has implications beyond cost. Frequent substitutions — a common reality during shortages — can introduce variability into clinical workflows and increase the risk of medication errors. Maintaining more consistent inventory helps preserve safety and predictability, she said. "When you have to inject an alternative into the system, you are going to inject risk," she said. While efforts such as the U.S. Pharmacopeia's vulnerability list highlight important upstream risks, Dr. Jarzyniecki said they do not replace the need for internal visibility and control. For pharmacy leaders, the priority is not just knowing which drugs are at risk, but understanding how those risks translate inside their own operations. "You've got to know what's going on in your system and be able to make proactive decisions," she said. n

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