Unanticipated Emergencies and the Pharmacy: What's Your Plan?

Pharmacies play an important role in assisting patients after a disaster, so they need to have a disaster plan in place and conduct periodic reviews to ensure that it will work when needed.

The list of potential natural disasters is long: hurricanes, tornados, windstorms, floods, ice storms, and even a new weather phenomenon—derechos. It’s no wonder that weather forecasters invent fantastical names like SnOMG, Frankenstorm, and Snowmageddon. Although these monikers bring a touch of humor to serious weather situations, storms and their aftermaths can seriously tax the health care system in general and pharmacies in particular. Just a year ago, a swath of the East Coast was battered and then flooded by Hurricane Sandy. As the most accessible health care professionals, pharmacists played an important role in helping patients in the affected areas cope.

As residents fill their bathtubs with water, secure windows and doors, and refill prescriptions in advance of a coming disaster, health care personnel also prepare for the worst. If the disaster sweeps in unannounced or causes damage that interrupts utilities for longer than expected, everyday life can be transformed into sheer havoc.

Constant State of Readiness

Pharmacies need to be prepared for any disaster. This means being in a constant state of readiness to respond. Pharmacists should conduct periodic reviews to ensure that:

• Management knows its minimal staffing needs during various types of emergencies, keeping in mind that some employees will be unavailable for work
• Employees know the expectations—whether and when (and sometimes where) they should report to work and whom to call if they can’t
• Supervisors will deal fairly with employees (rotate first responders, create clear procedures explaining who must report), and recognize that sometimes it’s safer for people to stay home
• Leave and pay policies for employees who cannot or choose not to report for work during or after disasters are written and fair and reasonable
• All information systems and critical equipment are connected to generators and capable of working through a disaster
• Patient records are easy to understand, printed in a format that other health care providers can understand, and include immunization histories

The best way to ensure these items are in order is to run mock disaster drills every 90 to 120 days. Pick a time, announce a disaster scenario, and ask employees to behave as if they were experiencing a real disaster. Review every policy and planning document, and check to make sure they are up-to-date. Check all back-up systems to ensure that pharmacy staff will be able to provide continuous care to patients. Contact your information system provider and make sure you have a current back-up plan. Assign some staff to play “patient” and arrive with typical problems—lost medication, first aid needs, or a request for records.

Worst Case Scenario

Every disaster is different, and even the best planning may be insufficient. Some people are skeptical of warnings and choose not to prepare for impending disasters at all, especially if recent warnings have turned out to be false alarms. After a disaster hits, gasoline for back-up generators often becomes scarce, and roads can be closed for weeks. Seniors are at increased risk of suffering in disasters—they frequently fail to prepare sufficiently. All residents in the disaster zone have immediate needs: maintaining or finding shelter, food, and water, and treating injuries and infection.

Every pharmacist and pharmacy needs specialized skills during-post disaster periods. In these instances, pharmacies’ visibility in the community makes us go-to resources for our community’s residents. Patients may call or visit the pharmacy preferentially during the disaster, since many other stores may not be able to open. An important first step is to determine and appreciate patients’ compromised living environments. At the same time, we need to assess the health care system’s limitations. One rule of thumb: treat acute injuries first and triage chronic conditions to a lower priority.

New technologies can be very helpful during disasters. Smartphones have made it easier to share or spread information via social networking sites. For example, utility companies now text progress reports to customers’ cell phones and news organizations send progress updates. Pharmacies can use their websites and social networking tools to let patients know that they are open and describe the services they are offering. Work with your information system vendor to ensure that your system will work during disasters.

Focus on Patients

When disasters destroy or damage housing, patients often lose their medications. They may also be forced to seek shelter in new places—their vehicles, public housing, hotels—that offer inadequate medication storage conditions. Rely on your records to determine which medications patients need and always address the conditions under which they will be stored. In addition, print paper copies of patients’ medication regimens if the disaster is expected to be prolonged so they can take them with them if they must evacuate.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.