What Is a Specialty Pharmacy?

Many of us are used to hearing about maintenance medications – that is, medications that people take regularly to manage conditions like high blood pressure and high cholesterol. There are also common medications we are used to being prescribed when we are sick, such as antibiotics like amoxicillin or steroids like prednisone. We can just get these through our standard local pharmacy since they are common and typically readily available. 

However, you may be less familiar with the concept of specialty drugs, and, in turn, the specialty pharmacies that stock them. Specialty drugs are most commonly used to treat cancer and chronic diseases like rheumatoid arthritis, multiple sclerosis, ulcerative colitis, Crohn’s disease, and more. They may also be used during fertility treatment or in the field of endocrinology. By definition, they are drugs that require special handling, treat rare diseases, require ongoing clinical assessment or monitoring of side effects, and/or have a limited distribution and can only be filled at certain pharmacies. 

Specialty pharmacies are becoming more of a necessity given the growing number of specialty medications. At GBMC, we are extremely fortunate to have a specialty pharmacy available onsite. Having our specialty pharmacy onsite allows us to take care of the patient comprehensively under one roof. The patient can get their medication while still on our campus. Many patients who need specialty medications are immunocompromised, and having one less place to travel helps to limit exposures that may lead to contracting viral/bacterial infections. By having our specialty pharmacy on campus, we are ensuring that our own providers and staff are caring for the patient from the time they arrive to the time they are discharged, using the same electronic health record. This allows for improved care coordination and better collaboration between all care team members. 

One of the challenges associated with specialty drugs is their cost. This can be a barrier to patients. I’m proud that our specialty pharmacy team has worked with Qualify Health to implement a financial advocacy process that identifies and helps patients with out-of-pocket expenses. These patients are connected to resources that range from copay cards and patient assistance programs to funding from various disease foundations and rebates from drug manufacturers.  

Thank you to Yuliya Klopouh, PharmD, Executive Director of Pharmacy Services, and her team for bringing this wonderful offering to fruition. Their efforts to make specialty medications more accessible to patients with same-day delivery, onsite delivery to appointments, and connection to financial resources is leading to better care experiences and is truly the type of care I would want for my own loved ones. I am excited to see this important work continue, especially as we expand our specialty pharmacy services into our new GBMC retail pharmacy that will open in the new Louis and Phyllis Friedman Building as part of the Promise Project. 

Baltimore’s Best Hospital; One of America’s Greatest Workplaces 

We are honored that GBMC was recently named Baltimore's Best Hospital by readers of The Baltimore Sun. This recognition is a testament to the dedication of the entire GBMC family who strives every day to provide the care we would want for our own loved ones. We take great pride in caring for our community, and I’m thankful to all who entrust us with their care. 

We are also thrilled to have been recognized as one of America’s Greatest Workplaces 2023 by Newsweek and data firm Plant-A Insights Group! We are proud of our workforce and strive to maintain a positive, welcoming, and inclusive work environment and are humbled to make this list.  

Navigating a Complex Campus

It's sometimes easy to forget that the stress related to healthcare goes beyond medical concerns. Not only must patients and their loved ones navigate complex diagnoses, treatment and the complicated world of insurance (and more), but they also must often navigate unfamiliar campuses just to find their appointments and access their care. 

Unfortunately, GBMC’s hospital campus is no exception to that rule... We are built into a hill and have a very horizontal layout with three medical office buildings rather than one tower with easy-to-follow guides for each floor. Nearly every day, I encounter patients and visitors who are lost, and I think most staff and volunteers who frequent the hospital can relate. 

As I help these patients get to where they need to go, even I sometimes need to refresh myself on practice locations and building numbers. If a patient asked you how to find 6565 N. Charles St., would you remember that is the address for Physicians Pavilion East? It’s not something that I necessarily have memorized, although it would benefit us all to have that information on the fly so that we can be as helpful as possible when people are lost and stressed. 

Given this, I want to remind staff who come to the hospital about a few simple resources readily available at your fingertips so you can more easily help people find their way on campus.  

• You can bookmark this link on your phone for easy access to the campus map and building address information in one location: https://www.gbmc.org/patients-and-visitors/maps-and-directions. 
• 
  I encourage employees to download the GBMC wayfinding app by clicking here. This way, if you ever happen upon someone who is lost, you can easily pull up the app, enter the location patients are looking for and follow real-time navigation prompts. 
• If you are able, try to memorize our building numbers on North Charles Street in case patients don’t have the actual building name information handy. (You can also access these on our website of course, as mentioned above.) 
• Main Hospital: 6701
• Physicians Pavilion East: 6565 
• Physicians Pavilion North: 6535  
• Physicians Pavilion West: 6569 
• South Chapman: 6545 
• Brush up on the most convenient parking locations for each building: Lily for the Main Hospital, Iris for PPE and Tulip for PPN. For patients going to PPW, there are limited spaces available in Daffodil due to necessary repairs, so Iris is the next best alternative. And patients can always consider using the valet services available at PPW or the Sherwood Loop. Once the Promise Project’s new parking structure is complete, there will be more options. 

Do you have any ideas on how we can improve wayfinding? Or do you have any success stories related to how you’ve guided patients to your practices and departments? I’d love to hear your ideas in the comments. 

Thank you to everyone who takes time to walk people who are lost to their destinations on campus each day. It is one small way we can help alleviate some of the stress that comes along with seeking healthcare, and I appreciate all who take the extra time out of their days to assist our patients, visitors, new employees, and anyone who is less familiar with our campus. 

Addressing Workplace Violence and Staff Safety

Healthcare facilities are high-stress environments. This is one of many factors putting healthcare workers at higher risk of experiencing incidents of workplace violence, which can come in numerous forms – including (but certainly not limited to) physical assault, abusive language, threats, sexual language, verbal harassment, and racial slurs.

A workplace violence survey conducted across the health system in 2022 shed light into experiences and concerns among staff. Many employees shared that they have encountered verbal, emotional, or physical assault and that the instances often involved a patient and/or visitor. Our own Nursing Practice Advisory Council (NPAC) voiced concerns that mirrored survey feedback.

At GBMC HealthCare, the safety of our workforce (and everyone that visits our facilities) is critical. You cannot experience the joy of helping others if you do not feel safe. Several initiatives to improve staff safety are already underway (with more to come!). Thank you to Cate O’Connor-Devlin, MSN, RN, Director of Emergency Preparedness, Safety, and Security; Carolyn Keller, MS, RN, NE-BC, FNE-A, Clinical Nurse Manager - Unit 47; and Nicholas Kokkinakos, Senior Manager of Safety and Security; for their leadership in these efforts. And thank you to the entire Workplace Violence Committee, comprised of representatives across all three work systems and our Nursing Practice Advisory Council, for guiding us in our improvement.

Some key changes that have been implemented or are on the horizon are highlighted below.

Easier Reporting

With the launch of the new STAR incident reporting tool, staff can easily submit a formal Workplace Violence Incident Report from their mobile device, computer, or the Infoweb. A dedicated workplace violence icon was added to the homepage of the tool for convenient reporting, and staff can check the status of their reports.

Training Opportunities

Although we’ve offered training opportunities for higher risk areas, like the Emergency Department and Unit 47 (formerly Unit 36) for some time now, we plan to enhance training for these teams. Additional workplace violence prevention courses have been scheduled and can be registered for in NetLearning. We participate in “Stop the Bleed” training, which will be incorporating workplace violence topics, and in the future, we plan to incorporate clinical self-defense training into classes.

We will provide more hands-on training opportunities to include simulation drills within the Simulation Innovation Learning Center to help staff to feel as confident as possible in difficult scenarios and educate them about how to stay safe and de-escalate situations.

Policies and Leadership Support

In November 2022, GBMC launched a zero-tolerance policy for verbal or physical workplace violence. Staff can view the full policy in PolicyStat for details.

In June 2023, GBMC implemented a new policy to help clinical staff navigate challenging situations. The policy introduced additional resources including a Behavioral Support Team, that can advise on appropriate next steps when a patient is exhibiting disruptive behaviors. Similar to an ethics consultation, staff can request advice from the Behavioral Support Team for non-urgent situations. Again, I encourage staff to visit the Infoweb and review the full policy in PolicyStat to become familiar with all available resources.

In addition to policy changes, we have added a workplace violence metric to our vision dashboard, so we routinely analyze data and continuously improve.

Thank you to all our staff, patients, and visitors for your support in making GBMC HealthCare a safe environment for both work and healing.

Unveiling Our Annually Updated Strategic Plan

Back in April, I gave you a sneak peek into our strategic planning process in my post “Looking Ahead to a Bright Future.” As promised in that post, I have more information to share and am excited about our new initiatives!  

The plan is broken down into a series of “strategic moves,” all developed in alignment with our vision and our four aims: 

• Our vision of becoming the community-based true system of care capable of providing every patient, every time with the care we would want for our own loved ones 
• And the definition of that care embodied in our four aims: the best health outcomes and the best care experience with the least waste of resources and the most joy for those providing the care 

I’ve summarized the strategic moves below, but we will share a more detailed plan, to include specific initiatives and objectives, with our leadership team and employees soon.  

STRATEGIC MOVE 1: Evaluate, plan, and execute innovative ideas to improve the experience for patients while also keeping our unique Maryland reimbursement model in mind. Everyone benefits when patients get the appropriate care, at the appropriate time, in the appropriate setting. We will seek to expand service offerings in the post-acute, diagnostic, and cancer care programs.  

STRATEGIC MOVE 2: Using data, develop and sustain a culture of continuous improvement and performance excellence that rewards our performance. We will continue to foster a culture in which our employees and leaders feel empowered, trained, and inspired to be part of a continual process for quality-of-care improvements. We will measure our progress through patient experience scores, value-based performance incentive dollars, and by minimizing incidents of patient harm.  

STRATEGIC MOVE 3: Redesign key work processes for care access, care delivery, and care transitions to prioritize an excellent patient experience to everyone, including historically marginalized populations. We will continue to emphasize preventive care services with the goals of reducing the prevalence of chronic disease, providing medical care and support for those diagnosed with chronic illness to keep them as healthy as possible, and encouraging the utilization of advanced geriatric and hospice care for those with serious and/or terminal illnesses when appropriate. We must ensure our services are easy to access with readily available appointments, responsive provider follow-up, and standardized work across the care continuum for chronic and serious disease management. 

STRATEGIC MOVE 4: Become the employer of choice in our market. Attracting, retaining, and engaging leaders, providers, nurses, and support professionals is essential to ongoing success, while we continue to diversify our workforce at all levels. 

STRATEGIC MOVE 5: Work with our suppliers, collaborators, partners, and other health systems to improve operational efficiency and effectiveness. In addition to other efforts, we will identify areas where we can streamline processes and collaborate with vendors on best pricing. 

STRATEGIC MOVE 6: Increase the philanthropic support for our programs and services and more closely align with the Marketing Department to grow market share. As a nonprofit organization, we appreciate the generosity of our donors, who ensure we are able to provide the critical services our communities truly need while removing barriers to care. 

To our GBMC HealthCare system leaders: Each of our strategic moves can connect to every employee, regardless of role, in some way. Be on the lookout for additional details in the near future to help you individualize action plans for your areas. And most importantly, as you review all the information we’ll be giving, please consider the “why" behind everything we do, remember your key stakeholders, develop goals that align with the plan, and enroll your teams using the Leadership System.