demands a bit of clinical creativity, constant communication with your
surgical team and plenty of hard work.
1. Monitor drug shortages daily.
Start by being proactive, not
reactive, when managing your facility's drug inventory. Review the live
list of drug shortages that's posted on the website of the American
Society of Health-System Pharmacists (ashp.org/shortages). The list
should be your go-to resource. Check it every day and sign up to
receive email alerts of new and resolved shortages. Dextrose is on it
right now. Bupivacaine, too. And fentanyl and ketorolac. Obtaining
various sizes of morphine and hydromorphone has also been prob-
lematic in recent months.
2. Stock up on drugs in shortage.
If a drug you need is on
shortage, scour the online inventories of your medication suppliers
and immediately order available supplies, suggests Thomas Durick,
MD, a consultant anesthesiologist with Envision Physician Services in
Walnut Creek, Calif.
Dr. Durick, the former medical director of a busy multispecialty sur-
gery center in the San Francisco Bay Area, recalls dropping a batch of
medications into his online shopping cart and clicking to confirm the
order — only to find the inventory he reserved seconds earlier had
vanished.
"The market is that volatile," he says. "If you put off ordering med-
ications that are in short supply, even for a couple hours, you might
come up empty."
Comparing current shortages to your facility's inventory should sit
atop your to-do list. As a consultant, Dr. Durick regularly visits 6 sur-
gery centers and is surprised that even the largest and busiest one has
only a single staff member who monitors drug shortages — on a part-
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