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topics, they cover strategic planning, contract provisions and negotia-
tions, and how to evaluate performance. That's something that hadn't
been available in the past. In the wake of the NECC scandal, there's
been increased emphasis on developing tools, resources and guide-
lines that help facilities know what to look for.
• Do quarterly audits. Is your compounder willing to provide quar-
terly reports that show what tests they've done and the results? You
want to know how many batches were rejected internally, and why.
Are there process problems? A problem with a certain product? You
should ask about cleaning, environmental sampling and monitoring,
too. If more bioburden is showing up, why is that? Has something
changed with equipment or the cleaning staff? How did this quarter
compare to previous quarters? You want to have as many eyes on the
process as you can.
• Be wary of evasion. You'll know if you're getting the proverbial
smoke screen or if somebody is hesitating to share data.
Compounders should be very willing to open up their records and
chat about what they're doing and what they're seeing. That trans-
parency creates comfort.
• Emphasize quality over price. When people are forced to try to
do things as inexpensively as possible, the system doesn't reward
quality. If one compounder seems much cheaper than everyone else,
the big question has to be why. What is it that they're doing different-
ly? There are always going to be those who want to push the enve-
lope. That means there's always going to be risk. All involved need to
have a clear understanding that delivering a quality product requires
time and a methodical process. — Joseph Coyne, RPh
Mr. Coyne (jcoyne@coyne-consultingllc.com) is an executive healthcare consultant
and president of Coyne Consulting in Mundelein, Ill.
