What started as a simple request for help from Johns Hopkins Bayview Medical Center’s pharmacy division to The Johns Hopkins Hospital has resulted in integrated pharmacy services between the two medical centers and significant shared savings.
In 2013, when Johns Hopkins Bayview’s pharmacy was in search of a new director and in need of interim leadership, Daniel Ashby, chief pharmacy officer for the Johns Hopkins Health System, and his colleagues saw an opportunity to do more than offer a temporary helmsperson. They began exploring strategies for how to share activities across the two hospitals, and that fall, a systemwide planning retreat gathered representatives from the pharmacies and administration from five Johns Hopkins Health System hospitals. The consortium looked at successful integration models from areas such as facilities and pathology.
A memorandum of understanding between The Johns Hopkins Hospital and Johns Hopkins Bayview, finalized in April 2014, identified 11 areas in which pharmacy could share services across its academic division, including strategic planning, compliance with regulatory affairs, fiscal management, and the scope and quality of services supporting safe medication use.
“We wanted to optimize our available resources,” Ashby explains. “We wanted to make sure that people within the system who had similar responsibilities were connected, we wanted to identify best practices within each hospital and share them, and we wanted to see what could be done to bring savings through performance improvement initiatives.”
The pharmacy at The Johns Hopkins Hospital, for example, set a performance improvement target of $3.1 million this fiscal year. Six months in, the division was projected to achieve at least $4.2 million in savings, Ashby says.
The direct cost savings reflect not only improved formulary management but also savings resulting from sharing services across campuses. For example, Sheila Lind, a senior financial analyst for the pharmacy, used to prepare a monthly analysis of drug spending and budget performance for The Johns Hopkins Hospital; she now does so for both hospitals. Bob Feroli, medication safety officer for The Johns Hopkins Hospital, travels to Johns Hopkins Bayview and the community hospitals to help them prepare for any upcoming Joint Commission accreditation surveys.
“I think the real key to success has been the engagement of leadership across all pharmacy departments,” Ashby says. “Our colleagues at Johns Hopkins Bayview, Sibley Memorial Hospital, Suburban Hospital and Howard County General Hospital all have recognized the value in working together.”