Four days after the July 13 announcement that Novant Health would cut 400 employees, it also shut down the night-shift pharmacies at hospitals in Matthews and Huntersville, two of the system’s four Mecklenburg County hospitals.
Administrators say the closings – from 11 p.m. to 6:30 a.m. – were planned and employees were notified.
Dr. Thomas Zweng, chief medical officer for Novant Health, told me the pharmacy closings should not affect nurses’ jobs or patient care because any questions are now being handled by pharmacists at Presbyterian Medical Center, Novant’s largest Charlotte hospital, near uptown.
“Patient safety is the top priority at Novant Health,” Zweng said. “.… But we also need to look at efficiencies.”
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Zweng said the system has cut pharmacy hours at several other hospitals – in Charlotte, Winston-Salem, Thomasville, Kernersville and Brunswick County – because of “low volume.” Having electronic medical records (EMR) allows pharmacists at Presbyterian to access patient records at Matthews, he said.
Even before the changes in Matthews and Huntersville, Novant’s Charlotte Orthopaedic Hospital had also moved to “virtual pharmacy” coverage through Presbyterian at night, Zweng said.
“With any change, there’s always some anxiety. (But) we’re not asking nurses to do anything outside their training,” said Denise Mihal, a nurse and senior vice president for Novant Health clinical operations.
Pharmacists still have “100 percent oversight,” checking drugs and dosages and making sure the drugs don’t interact negatively with other medicines. “All of that remains with the pharmacy and just happens to happen at Presbyterian in Charlotte instead of Presbyterian in Matthews,” Mihal said.
Carolinas HealthCare System, Charlotte’s larger hospital group, also uses the virtual pharmacy approach.
Six of the largest hospitals in the Charlotte area – Carolinas Medical Center, Carolinas Medical Center-Mercy and hospitals in Pineville, Concord, Monroe and Albemarle – have around-the-clock pharmacies.
But smaller hospitals without night-shift pharmacists rely on Mercy, according to spokesman Kevin McCarthy.
After hours, these hospitals submit medicine orders electronically to Mercy. A pharmacist reviews them and then sends messages to automated dispensing machines at the hospitals, and that allows nurses to access the drugs.
This method “meets all state, national and Joint Commission requirements that a pharmacist must review the order prior to dispensing,” McCarthy said. “Advances in EMR and technology now permit hospital systems to provide this service from a central location.”
Jay Campbell, executive director of the North Carolina Board of Pharmacy, said “remote medication order entry” has been authorized by state law for many years and is allowed in most other states. “It’s a means of keeping pharmacists involved in reviewing medication therapy” at community hospitals that can’t afford to have on-site pharmacists around the clock.