When the California State Board of Pharmacy revised its regulations to mandate a quarterly physical count of Schedule II medications starting April 1, it raised eyebrows. And concerns. And awareness.
That’s good, says Virginia Herold, executive officer of California’s board. “I can’t say the new policy was warmly accepted across the whole state,” she says. “And I acknowledge that physical counts are a lot of work. But we are strongly concerned that too many pharmacies are estimating — not physically counting. We are doing this in the interest of public safety, and helping pharmacies keep themselves out of trouble.”
New Inventory Management System?
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California used to mandate biennial C-II counts (the same as the DEA), so the move to quarterly was a bold statement. Is the Golden State setting a new standard? Will more state boards require more frequent counts and levy stricter penalties for noncompliance? That remains to be seen. Says Herold, “When it comes to opioid control, we are all looking over the fence seeing what our neighbor is doing.”
In other words, inventory rules will likely tighten before they relax. What does this mean for pharmacy managers? More frequent counts drain staff time, thus impacting profitability. Pharmacy management is tasked with finding the most economical, time-saving method possible, since physical inventory should be done during off-hours when prescription filling can’t deplete stock levels. Hand-counting is more time-consuming during a physical inventory (taking 2 to 3 times longer) and significantly less accurate than a bench-top counting device (95% versus 99+%). In an age where pharmacies are mired in red tape for being off even one Norco, why would pharmacies consciously opt for the higher risk of a tray and spatula? There are three commonly cited reasons: 1) habit, 2) fear of new technology, and 3) cost. All three reasons are feeble at best, and dangerous at worst, says David Adsit, director of pharmacy operations for Gouverneur, N.Y.-based Kinney Drugs.
“To err is human, and if you’re counting by hand, the chances for error are a lot higher than a machine,” Adsit says. “You couple that with the efficiency and time savings, and it just doesn’t make sense to NOT use a counting machine.”
Kinney Drugs, which operates 77 pharmacies in New York state and 22 in Vermont, has used Kirby Lester counters since the late 1980s. The tabletop-sized machines are as vital to Kinney’s inventory strategy as any computer software. And their fleet of pill counters gets plenty of work; every Kinney location performs monthly C-II inventory counts and quarterly C-III to C-V counts, supervised by a pharmacist. Additionally, Kinney pharmacies back-check every narcotic stock bottle with the counting machine immediately after every Rx fill. “By maintaining solid control, we are preventing narcotics from getting into the wrong hands. The chances of something being stolen or lost is dramatically reduced. It’s a powerful deterrent,” says Adsit.
Gordon Wong, owner of Knolls Pharmacy, Pacific Palisades, Calif., knows some of his colleagues are scrambling with California’s new inventory frequency rule. He’s even received calls to borrow his Kirby Lester counter. “I don’t know how anyone could do a physical inventory count without a tablet counting device,” Wong says. “Without my Kirby last Saturday when I did my inventory, I would have been one unhappy guy. Easily it would be double the time, and more than double the worry.”
Albertsons-Safeway pharmacies in California and across the country know they’re well-situated for inventory accuracy. Since 1973, they’ve standardized on Kirby Lester counters, now in all 2,100 locations. “The time saved as well as the improved counting accuracy provides our pharmacists more time to counsel and educate patients, leading to a win-win situation for everyone involved,” says Dain Rusk, Albertsons group VP of pharmacy operations. CT