Crisis management in Finnish hospital pharmacies during the COVID-19 pandemic.

Abstract

Background: Although hospital pharmacies have played a central role in managing the COVID-19 pandemic, there is a lack of crisis management theory-based empirical research on the topic. The purpose of this study was to fill this gap in the Finnish context and identify areas for development to improve future crisis preparedness.

Methods: A national cross-sectional survey was developed based on crisis management process models and sent to all hospital pharmacy heads (n = 21) during the second wave of the pandemic in October-November 2020. Descriptive statistics were calculated, and qualitative data from open-ended responses were studied using deductive content analysis. The results were confirmed and enriched through data triangulation with six semi-structured interviews of purposively selected hospital pharmacy heads in March-May 2021.

Results: The response rate was 57% (n = 12). Following the onset of the pandemic, the risk perception of a crisis concerning pharmaceutical supply chain rose from 58 to 100%. A pre-existing pandemic preparedness plan was available in four (25%) pharmacies. Seven (58%) pharmacies developed a new plan. A pandemic crisis team was established in four (33%) pharmacies. Changes in internal communication and management (92%), clinical pharmacy services (67%), medicine supply (58%), procurement (42%), and pharmaceutical production operations (25%) were implemented. Collaboration with peers or other actors in the pharmaceutical supply chain increased or improved in nine (75%) hospital pharmacies, whereas in three (25%), it decreased or was unchanged. Mandatory reserve stockpiles provided a buffer for the increased need for emergency medicines. Positive and negative experiences of the pharmaceutical supply chain's crisis response indicated an unequal distribution of medicines and crisis management-related information.

Conclusions: Crisis management process models provided a holistic framework for analysing the pandemic response in hospital pharmacies. The study provided an alternative data collection approach by utilising process models in the development of the survey instrument. Preparedness of hospital pharmacies could be improved with pre-established crisis teams and plans, and data management systems providing easily accessible information to support decision-making. Developing prerequisites for coordinated information sharing and equitable distribution of medicines is essential to ensure effective crisis response, equitable medicine availability among hospitals and patient safety.