Background information: The COVID-19 pandemic has put a lot of strain on health systems since 2020. A review of the Swiss hospital pharmacies (HP) actions undertaken and challenges experienced during the first wave was performed to improve pharmaceutical management of future health crises.
Purpose: To propose an overview of the actions undertaken by HP across Switzerland as they responded to the challenges encountered during the first wave of the COVID-19 pandemic and to provide information to improve pharmaceutical management in future health crises or disasters.
Method: An electronic survey was sent to all head of HP in Switzerland. The questionnaire was organized into eleven clusters of questions and covered many topics regarding the management of the first wave of COVID-19. Data collection was conducted from May 19 to June 19, 2020.
Results: Analyses were performed with 43 answers (66%) out of 65 questionnaires sent. At the peak of the first wave, 59% of HP reported that some of their workforce had to change jobs: from <10% of change (21% of HP) to >50% of change (3% of HP). Standard operating procedures or pandemic plan were previously available in 41% of HP. Crisis unit has been created in some HP mainly with the head pharmacist (61% of HP) and a member of the pharmaceutical logistics unit (34% of HP). Drug availability in COVID-19 wards was managed by increasing existing stocks (54% of HP) and/or creating extra storage space (51% of HP). Reserve supplies had been anticipated in 56% of HP. 51% of HP created specific drug lists for wards treating COVID-19 patients although 15% of HP created partial drug lists. The drugs contained in these lists were mainly COVID-19 specific treatments (83% of HP), sedatives (81% of HP), anesthetics (77% of HP) and antibiotics (73% of HP). Remdesivir ran out of stock in 26% of HP and two drugs generated the most concern of shortages: propofol (49% of HP) and midazolam (44% of HP). In some HP, a pharmacist was present at ICU to support medical staff (24% of HP) and a pharmacy assistant was also dedicated (22% of HP) to resupply wards with drugs. Specific documents were drawn up to respond to medical and care personnel’s needs with regards to drug administration (29% of HP), drug preparation (29% of HP) and treatment choices (24% of HP). 47% of HP implemented specific hygiene measures (e.g. disinfection of surfaces and equipment). 77% of HP experimented problems procuring hand sanitizers and among them 53% manufactured it. 28% of HP introduced debriefings in teams.
Conclusion: HP in Switzerland have encountered many challenges related to the COVID-19 disaster and had to find solutions quickly and effectively. Major concerns have been identified, underlining the critical role of HP in such crisis. Managing and facing complex pandemic response scenarios requires a disaster management plan, communication, staff flexibility, teamwork, and collaboration. Therefore, team briefing and debriefings are more than important to establish a climate of trust.