Crisis management in the pharmacy

David BallScenario 1: An inspector from the state board of pharmacy visits your pharmacy. A sterile compounded product that you made was observed by a patient to have particulate matter floating in the vial. The board orders you to recall every single compounded medication made in the last 90 days and to notify all your patients and every media outlet in your market.

Scenario 2: You come into your pharmacy one morning to find that a sprinkler head has failed and you have several inches of water on the floor. Your computer server is flooded and tens of thousands of dollars’ worth of inventory that was stacked on or near the floor is ruined.

Scenario 3: Something seems “off” with the inventory. The order sizes have been increasing monthly, but revenue is flat. The composition of the drugs ordered has been changing too. A tech comes forward and tells you that one of the pharmacists is addicted to pain meds and is feeding his addiction with the drugs in stock. You call the DEA; agents make an arrest. The addiction and larceny become front-page news.

Have a plan

As a pharmacist and business owner, you could experience any or all of these scenarios. They have happened to pharmacists across the country at one time or another. While these situations are all threats, they are controlled threats - if you have a plan in place to deal with them.

Resources. The reality, however, is that most pharmacies have no crisis plan. They have never thought through a step-by-step response to such a situation. They have never evaluated their insurance coverage to make sure that they have enough. They have never identified the resources, such as a public insurance adjuster or a public relations firm, that they would need if these circumstances were to befall them.

IT. Many pharmacies also are not prepared for a major strike to their IT systems. While most pharmacies back up their data regularly, in many cases the backups are kept onsite. A fire or some other major event at the pharmacy could render the backups useless.

Reputation. But the most important reason for a crisis plan is that pharmacy owners have spent years building a reputation. That reputation is gold. It can be undone in a matter of days, if a series of media reports calls into question the quality of the products dispensed by that pharmacy.

The evidence is everywhere to see. In just the last year and a half, compounding pharmacies that enjoyed good reputations were put out of business after reports of contamination or an inquiry or action by the board of pharmacy.

What you need

How to build a crisis plan:

• Identify who will serve on your crisis team and what their roles and responsibilities will be.

• Establish an internal protocol for notifying and activating staff. A quick and simple phone tree will ensure that everyone is notified. This is essential, because in a crisis you need all hands on deck.

• Inventory the external resources that you will need and obtain emergency contact information for each. Include a lawyer, a public relations firm, and a banker. A credit line should always be in place, as well.

• Create media statements for different contingencies and have them ready them in the plan.  

Review and drill

You may need help developing the plan; there are firms that specialize in this work. The finished plan should be reviewed with the management team and regular drills should be conducted.

We live in a world that seems increasingly uncertain, and the pharmacy profession has never undergone greater scrutiny than it experienced in the 22 months since the New England Compounding Center tragedy killed more than 60 people and sickened more than 700.

A crisis plan is the antidote to uncertainty and risk; it is as vital to your pharmacy as the life-saving medications that you prepare for your patients.

David Ball is the president of Ball Consulting Group, LLC (http://www.ballcg.com), of Newton, Mass., a public relations and crisis management firm that works with the pharmacy profession.