Is your Pharmacy Prepared for a Natural Disaster?

Is your Pharmacy Prepared for a Natural Disaster

Most pharmacies are prepared for theft and fire in some sense but what about Natural Disasters or an “Act of God” as many of our primary insurance carriers refer to them.  What is classified as a Natural Disaster?

The “Websters” definition is as follows: “A natural disaster is an act of nature of such magnitude as to create a catastrophic situation in which the day-to-day patterns of life are suddenly disrupted and people are plunged into helplessness and suffering, and, as a result, need food, clothing, shelter, medical and nursing care and other necessities of life.  Medication and the proper and safe dispensing of such falls under this category and its disruption and possible effects on your pharmacy can be far reaching as well as extremely rewarding. I will later explain.

Natural Disasters here in the New York Metro area brings to mind Hurricanes and Blizzards as the most periodic such events. However…Flooding, Tornadoes, Forest Fires, the Terrorist attacks on 9/11, and the more recent riots in major cities throughout the country also epitomize the fine line between a Natural Disaster and ANY event that creates helplessness and suffering on a grand scale.  Just this past week pharmacies from around the country have sent mobile units  and meds to help survivors of Hurricane Laura down in Louisiana and Texas. As of this articles post Fema reports: Seven hospitals and more than 30 pharmacies across the region remain closed. Additionally, 23 hospitals, 40 nursing homes, and six intermediate care facilities are on generator power in Louisiana.

When pharmacies close Patient Access is supressed and when access is supressed people will go on without all important medications and then repeat their own cycle of clinical decline due to whatever conditions ail them. This will in turn throw more patients back into the healthcare system!   In order to plan you and your pharmacies’ survival the following directives are a good start.

Formulate your plan and have written lists to follow and doublecheck.  Be sure at least one or two other key employees and/or store partners also have this list.  You should also have lists with names and numbers of all your stores’ employees and an emergency action plan such as a phone tree for vital store information to be passed out in times of emergency. Your most important vendors and the key people from those organizations is also a good insurance policy for store assistance and help once a disaster occurs. Below are a few other lists of important strategies with quantifiable steps to consider. A store that is able to maintain its presence in the community regardless of your physical locations’ condition will most likely survive and thrive post disaster.

Communications

Assemble a list of all employees with contact information including cell phone, home phone and e-mail addresses.

1. Consider turning your list into a call tree where you contact several employees who will be charged with the responsibility of calling others within your organization.  Make sure that the employee at the bottom of the call tree contacts the originator of the message so that you can evaluate whether the messaging changed in the hand off from employee to employee.
2. Assemble a broadcast fax or email list of local radio and television stations with their news phone number, and a list of physician offices and hospitals.
3. Obtain from the County Manager’s office a contact at the County Emergency Management Headquarters.
4. Make list of contact information for wholesalers and important vendors
5. If the pharmacy is to be closed and/or evacuated the appropriate supervisory personnel should be notified.
6. Notify local radio and television media if the pharmacy is to be closed.
7. Notify the emergency management contacts for the county in your affected area. County Emergency Management Contacts can be located HERE
8. When the pharmacy reopens notify all pharmacy personnel; physicians and hospitals; local radio and television media; emergency management and emergency management contacts for your county.

Facilities and Security

1. Obtain waterproof covering material for later use.
2. Anticipate power outages; in some cases a portable generator may be advisable.
3. Ice and coolers should be available to store refrigerated products.
4. Store flammable materials appropriately.
5. If the pharmacy computer is down prescriptions can be dispensed manually. Labels can be typed or handwritten using a waterproof pen if possible. If possible have a set of the stores’ pre-printed labels off-site with empty bottles so you can begin filling with your information asap.
6. Printed drug information may not be available but patient counseling must still occur.
7. Refill authorizations may be difficult or impossible to obtain.
8. If the pharmacy is to be closed and evacuation is warranted the pharmacist-manager should produce 2 sets of backup tapes or disks of all drug inventory and all prescription information. One set of information could be kept in a safe place and another kept off-site in the possession of the pharmacist-manager.  Any media that contains confidential patient health information should be kept securely and accounted for to prevent any breech of confidential information. If your vendor currently offers off-site backup disaster recovery of your data you should enlist with this service immediately. We at Point of Care systems deploy this and many other forms of data recovery to find out more please click here.
9. Prior to evacuation, computers should be shut down and covered with waterproof material. If flooding is expected the computer should be disconnected from the terminals and moved to a safe area.
10. When the situation is stabilized the pharmacy personnel should be notified to take steps to restore the integrity of the pharmacy setting.

Controlled Substances

1. If controlled substances are lost in a disaster the pharmacist-manager needs to contact the Regional DEA offices.
2. Schedule II drugs should be moved to a locked, secure place. A safe may be used but is not required. Other products such as prescription drugs should be moved, if possible, above the ground-floor level and covered with waterproof materials.
3. It may be necessary to complete a loss form – rules vary by state
4. If prescriptions have been dispensed while the computer is disconnected please note that the code of federal regulations for controlled substances has policy on what needs to happen.  The rules are as follows here:

“In the event that a pharmacy which employs such a computerized application experiences system down-time, the pharmacy must have an auxiliary procedure which will be used for documentation of refills of Schedule III and IV controlled substance prescription orders. This auxiliary procedure must ensure that refills are authorized by the original prescription order, that the maximum number of refills has not been exceeded, and that all of the appropriate data are retained for online data entry as soon as the computer system is available for use again.”

A True Story

Rob O’Brian is President of the Joplin Missouri Area Chamber of Commerce, he recently gave an update on the City’s 531 businesses destroyed or severely damaged by an EF-5 tornado which tore through the town May 22, 2011 killing 161 persons. “David and Sheree Starrett’s Medicine Shoppe Pharmacy on 20th Street was flattened that Sunday evening. Monday morning while planning their next course of action, a customer called to offer them use of a vacant building on 32nd Street. It didn’t look like it would work for them. It just so happens though, that right across the street  was empty and had a sign in the window which read For Lease. They opened up 5 days later on that Saturday after the tornado.” With, as David Starrett points out, the help of kind hearted strangers, good friends, good luck, good government, good insurance and great employees. “So many people coming in to help the whole town. It seemed on every parking lot people were barbequing and feeding people. We had ladies in SUV’s jumping out with cases of water and personal pizzas for 15 crew member doing our cleanup. Our insurance company brought a crew in, and was very responsive. In the mean time because the powers that be declared this a disaster area, my state license, and federal narcotics licenses, arrived by Friday, and by golly we opened up that Saturday. We had so many folks that came by that didn’t really need anything, they wanted to check on us and see how we were, but they also wanted to tell their stories. So we did a lot of listening. A lot of crying and hugging. So really, we feel quite fortunate, number one to serve our customers. To get back open as soon as we could was so important.”  Happy to report that this pharmacy is still alive and thriving today in the very same community in Joplin, Missouri almost ten years post their own natural disaster!!

Most of your local pharmacy societies on the state level should have related material and/or important contact information should you incur a natural disaster at your store!

Some addtional resources for Emergency and Disaster Preparedness and Response Planning: A Guide for Boards of Pharmacy

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