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PURPOSE: To assess the current state of burnout among pharmacists who work in hospital and health-system settings in North Carolina. METHODS: The Maslach Burnout Inventory-Human Services Survey for Medical Professionals was used to assess burnout in this study. This survey measures 3 subscales of burnout: emotional exhaustion, depersonalization, and personal accomplishment. In addition to the Maslach Burnout Inventory, the survey asked questions addressing various modifiable and nonmodifiable demographic factors. To distribute the survey, an email listserv of all pharmacists licensed in the state was obtained from the North Carolina Board of Pharmacy. The survey was distributed through email in June 2018. A follow-up email encouraging participation in the survey was sent 2 weeks later. The survey was open for a total of 4 weeks. RESULTS: The survey was delivered to 2,524 pharmacists; 380 responses were received (15.1% response rate). Of the 380 individuals who responded, 357 completed the entire survey (93.9% completion rate), and 198 pharmacists (55.5%) were at risk for burnout. Following multivariate logistic regression, 3 factors were significantly associated with increased risk of burnout: female gender, working in a primarily distribution role, and longer hours worked per week. Two factors were significantly associated with decreased risk of burnout: being aware of burnout resources and working 4 to 6 months with learners. CONCLUSION: The results of this statewide survey revealed that more than half of hospital and health system-based pharmacists are at risk for burnout.

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Purpose: The purpose of this article is to share experiences after the development of a health-system pharmacy administration residency with a MS degree and express the need for additional programs in nonacademic medical center health-system settings. Summary: Experiences with the development and implementation of a health-system pharmacy administration residency at a large community teaching hospital are described. Resident candidates benefit from collaborations with other health-systems through master's degree programs and visibility to leaders at your health-system. Programs benefit from building a pipeline of future pharmacy administrators and by leveraging the skills of residents to contribute to projects and department-wide initiatives. Tools to assist in the implementation of a new pharmacy administration program are also described and include rotation and preceptor development, marketing and recruiting, financial evaluation, and steps to prepare for accreditation. Conclusion: Health-system pharmacy administration residents provide the opportunity to build a pipeline of high-quality leaders, provide high-level project involvement, and produce a positive return on investment (ROI) for health-systems. These programs should be explored in academic and nonacademic-based health-systems.

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PURPOSE: The self-development potential of pharmacy management practitioners related to self-management, team development, and network management was assessed. METHODS: A survey instrument consisting of 12 self-assessment questions and 11 questions about demographics was distributed to pharmacy management practitioners to assess their abilities to manage themselves, their teams, and their networks. The tool was distributed by e-mail hyperlink to 190 potential respondents. Only surveys from respondents who had a pharmacy degree and direct supervisory capacity were analyzed. Respondents rated their progress toward meeting the three imperatives on a scale of 1-5. Responses to the questions were analyzed as ordinal data, with median responses used for assessment. RESULTS: A total of 160 responses were received via e-mail, 149 (93%) of which met the inclusion criteria. About half of all respondents were practicing at institutions of 600 beds or more and supervised at least five employees. The majority of respondents identified their abilities to manage themselves, their teams, and their networks as areas of strength but also acknowledged that using all three of these skills on a daily basis was an area of opportunity. Respondents generally identified management of their network as an area needing work. CONCLUSION: The majority of survey respondents identified their skills in self-, team, and network management as areas of strength. Respondents generally identified management of their network as an area needing work. Respondents also identified the use of all three imperatives on a daily basis as an area of opportunity for improvement.

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PURPOSE: The experience of health-system pharmacy administration (HSPA) residents in a longitudinal human resource (HR) management program is described. The subsequent benefits to the residents, department, and profession are also discussed. SUMMARY: Postgraduate year 2 HSPA residents at an academic medical center desired more responsibility for managing an operational area. To this end, a program was created in which these residents directly manage a small group of pharmacy technicians and report to a clinical manager or assistant director with oversight responsibility. These "resident managers" are responsible, under the direction of the area's clinical manager, for the personnel, schedule, time and attendance, and HR activities of the area. Resident managers have led and sustained operational improvement projects in their areas. In addition to providing learning experiences to residents, the HSPA residency program has also improved the operations of the areas in which these residents work. Benefits to the residents include conducting annual performance evaluations for employees with whom they have a relationship as it is a task every administrator completes. Resident managers at UNC have consistently stated that this longitudinal HR experience is one of the most rewarding and most challenging experiences offered in the two-year HSPA residency. The involvement of HSPA residents in longitudinal management responsibilities furthers residents' leadership success by providing trained managers who are ready to immerse themselves into practice postresidency, having employee engagement and HR skills as well as experiences with leading operational improvements. CONCLUSION: A longitudinal HR management experience was successfully incorporated into an HSPA residency combined Master of Science degree program.

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PURPOSE: An objective methodology to guide decisions by hospital pharmacy departments on the best use of clinical pharmacist personnel is described. SUMMARY: To help determine the optimal deployment of state-licensed Clinical Pharmacist Specialist (CPS) staff, a task force led by the pharmacy department at University of North Carolina (UNC) Hospitals developed an objective approach to evaluating the relative need for and potential impact of CPS expertise within the medical center's many service units. After analyzing several years of patient census and medication-use data and using information from proprietary databases (Thomson Reuters) to calculate a "service-specific pharmacy intensity score" for each hospital service, the task force identified five staff-allocation metrics best suited to the medical center's service-based pharmacy coverage model. By applying the methodology, it was determined that CPS expertise was most needed in the UNC Hospitals adult medicine oncology service, the bone marrow transplant service, and the medical and neonatal intensive care units. The tool was initially used to validate the pharmacy department's existing human resource allocation and has since been used to guide budgeting for and deployment of newly added CPS positions. CONCLUSION: A novel tool to guide the application of pharmacy human resources incorporates the objective criteria of patient census, patient acuity, teaching involvement, drug expenditures, and use of high-risk medications. The tool can be used to determine the appropriate allocation and placement of clinical pharmacist resources in a service-based coverage model.

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PURPOSE: Process changes in a hospital pharmacy's batch preparation of sterile products to reduce product and human resource waste are described. SUMMARY: The pharmacy information system and direct observation were used in the collection of data on the existing i.v. room process, which generated batches of drug products every 12 hours. The daily numbers of doses prepared and doses credited, the percentage of doses credited, the cost of wasted doses, and the number of pharmacy technician hours wasted in the process were recorded. After a change to every-4-hour batch preparation and a modification of the schedule for delivering products to nursing units, data were again collected to determine savings of waste and costs. Fewer doses were prepared daily in the new batch process. The percentage of doses credited daily decreased from 26% to 18%, and pharmacy technician workload decreased by 3.05 hours. The reductions in waste led to a projected annual product cost saving of $122,000 and a workload reduction of 0.5 technician full-time equivalent. CONCLUSION: The implementation of a new i.v. room batch process improved operational efficiency by reducing the production of waste and led to a substantial projected annual cost saving.

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