Upfront Healthcare Magazine Issue 1 by Specialty Rx

AFTER LASIK Is Corrective also Protective? PAGE 12

STAFF DOESN'T NEED A STICK Learn Smarter Member Motivation Tactics PAGE 14

INSURANCE BUNDLE PAYMENTS ARE HERE TO STAY. Is your care model? PAGE 14

GERIATRIC NUTRITION Why it should get better with age. PAGE 14

Upfront Healthcare // September 2016

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Executive Director Joseph Kubulak editor-in-chief Mira Bronstein assistant editor Mayer Silver design Rebecca Grunwald Joy Hoberman Marketing GCNY Marketing MAIN OFFICE: 1449 37th Street | Suite 507 Brooklyn, New York | 11218

September 2016

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Contents

6 10 14 Industry Currents

Story One

Some Text About the Story Some Text About the Story Some Text About the Story

22 Story One

Some Text About the Story Some Text About the Story Some Text About the Story

Joe Kubulak Credentials

After Lasik with Dr. Michael Savetsky

Upfront Healthcare // September 2016

Specialty Rx Advertisement Spread

Upfront Healthcare // September 2016

TRAJECTORY

Long Term Care Industry According to a report published in July 2016 by Research and Markets, a leading market research firm, the global Long Term Care (LTC) market is expected to reach $1.1 trillion by 2024. The boom is primarily due to three factors: the increase in public awareness of different home health care facilities, increasing and more comprehensive medical coverage, and the aging population. According to the US Census Bureau, the “65 and over” population in the US in 2012 numbered 43.1 million. This population is projected to increase to 84 million by 2050. Other key findings include:

→ Home healthcare is growing significantly in developing countries thanks to social changes, double-income households, and increasing need for geriatric care.

→ Hospice care is the fastest growing market due to rising incidence rates of Alzheimer’s, dementia, and post-hospital care.

→ North Americans comprised the majority of the Long Term Care market in 2015, which is driven by the aging population, government support, and

AHCA/NCAL

awareness of home healthcare services. ●

2016 Awards

UP TO DATE

What’s New in LTC Insurance? As people age, performing simple tasks become ever more challenging. Many choose to spend their later years in care facilities to ease personal and familial burdens. For most, living in a long term care facility will require additional long-term care insurance, as Medicare and employer benefits cover only a fraction of the expense. Consumer Affairs recently announced its 2016 Top 10 Best Rated Long Term Care Insurance Providers, based on the following criteria: • Coverage & Considerations • Premium Costs

• Out of Pocket Costs • Coverage Limitations • Policy Options

Here are the top 10 best-rated long-term-care insurance providers: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

MetLife Mutual of Omaha Bankers Life John Hancock Transamerica Genworth Conseco ACSIA GuideOne MedAmerica ●

Every year, the American Health Care Association, in conjunction with the National Center for Assisted Living, awards providers of long-term and post-acute care services that exhibit performance excellence in a range of criteria as outlined by the Baldrige Performance Excellence Program. These criteria include Leadership, Strategy, Customers, Measurement, Analysis and Knowledge, Workforce, Operations, and Results. The recipients of this year’s most prestigious Gold Medal National Quality Award are: • Hughes Health and Rehabilitation in West Hartford, Connecticut • Maine Veteran’s Home in Scarborough, Maine • Altercare Post Acute Rehabilitation Center in Kent, Ohio Our heartfelt congratulations to the staff of these venerable facilities for their hard work and dedication to ensuring excellence in care for all their guests. ●

Upfront Healthcare // September 2016

NOTEWORTHY

RECREATION

Are You Administering Too Much Medication?

Super Seniors As the population of the world gets older, the fastest-growing age group is people over 100. About one in seven adults today is over 80 years old. Yet while the healthcare community is here to serve those who need it, we sometimes hear stories about seniors who are not content to sit and age quietly. Instead, they run marathons, graduate college, become models, and do amazing things we don’t expect “old people” to do. Here are four seniors who ignored the general expectation to give up on life, and went on to live large.

A growing number of elderly are prescribed multiple medications by multiple specialists who don’t communicate with each other. A lot of these drugs may not cause serious side effects, but that doesn’t mean that they benefit the individual either. The following facts are based on reports published by the FDA and the American Society of Consultant Pharmacists:

GEORGINA HARWOOD This

On average, individuals 6569 years old take nearly 14 prescriptions per year

South African Centenarian’s motto is “Do it now. Don’t delay.” For her 100th birthday, she did something that even some 20-year-olds wouldn’t dare do: She went skydiving. And if that wasn’t enough, she went swimming with sharks – right after jumping out of the plane! To some, age truly is just a number. JEANNIE EPPER For Jeannie Epper, the “greatest stuntwoman who’s ever lived,” according to Entertainment Weekly, the key to success is confidence. This senior super stuntwoman has performed in over 100 Hollywood films and earned many awards, including a Lifetime Achievement Award in 2007. At 70, she continues to perform stunts. HERSHEL MCGRIFF As the oldest

People aged 80 to 84 take an average of 18 prescriptions 15% - 25% of drug use in seniors is considered unnecessary or inappropriate Adverse drug reactions are responsible for 28% of elderly hospitalizations 36% of all reported adverse drug reactions involve the elderly

What does this mean for you as a caregiver? If your residents are on multiple medications, offer to have a physician and pharmacist discuss

things with them. Help them learn which ones to continue taking and which ones to stop based on their current condition. You will improve both their quality of life and their quality of care. ● Georgina Hardwood, skydiving on her centennial birthday

Lloyd Khan, safely skateboarding

driver to ever win a NASCAR race in 1989 at the age of 61, Hershel McGriff’s need for speed kept him driving well into his 80s. At 81, he competed in a national NASCAR race and finished in 13th place – defying the stereotype of the slow-driving senior. His secret? “Pilates.” LLOYD KHAN One day when he was 65 years old, Lloyd got on the skateboard of one of his son’s friends. He was immediately hooked. At 76, he can still be seen skateboarding around the Presidio and Golden Gate Park in San Francisco, carving the pavement with his longboard. When asked how he stays in motion at his age, he says simply that he tries doing something physical every day. ●

Upfront Healthcare // September 2016

HEALTH CHECK: AGE IS A NUMBER. SO IS NUTRITION. Nutrition is often overlooked and undiagnosed in geriatric assessment. Proper nutrition promotes general happiness, independence and longevity. Why then are malnutrition rates at an all-time high?

Upfront Healthcare // September 2016

identifying factors of malnutrition:

IS THE PATIENT EATING ENOUGH?

Factors Of Geriatric Malnutrition

NO Loneliness – many people do not enjoy eating alone Immobilitydecreased access to fresh and healthy foods Difficulty with food preparation

Nutrition is often overlooked and undiagnosed in geriatric assessment. Proper nutrition promotes general happiness, independence and longevity. Why then are malnutrition rates at an all-time high?

Taste buds atrophy, reducing the sensation of taste Depression

Malnutrition rates can be up to 85 % in long term care facilities. Malnutrition is a leading cause of reduced immunity levels, increased prevalence of degenerative diseases and many chronic disorders, including pain and inflammation, all increasingly common in aging adults. Health care professionals at nursing homes and long term care facilities should provide excellent medical nutrition therapy to their patients. It is of utmost importance that the facility offers a variety of food choices that satisfy the physical as well as cultural

food preferences of the patients. The World Health Organization states “micronutrient deficiencies are often common in elderly people due to a number of factors such as their reduced food intake and a lack of variety in the foods they eat.” When creating dietary meal plans, be careful not to simply look at their charted numbers, but rather look at the whole patient: their physical and psychosocial circumstances. The Short Nutritional Assessment Questionnaire for Residential Care (SNAQRC) is an excellent tool

with positive predictive value. It is recommended for diagnosing malnutrition in a home care setting and can be found at http://www. fightmalnutrition.eu/fileadmin/ content/malnutrition/Screening_tools/ SNAQrc_BMI_Engels_beide_delen_ samen.pdf

The infographic to the right helps identify factors of malnutrition. The first question to ask is if the patient is eating enough food. ●

WE MUST LOOK AT THE WHOLE PATIENT: THEIR PHYSICAL AND PSYCHOSOCIAL CIRCUMSTANCES.

Loss of Appetite; Less Food Intake

MALNUTRITION

YES Poor or unbalanced food choices Medication side effects (nausea and/or vomiting) Lack of proper nutrient absorption in the digestive tract

Superfoods in Senior Meal Plans It seems that every few months a new “superfood” starts trending. Often elderly people seemingly disregard current trends. Are the benefits from superfoods worthwhile enough to follow or will it be just as fleeting of a fad as Pokémon Go? “Consuming healthy, nutritious meals that include a variety of vitamins and minerals is beneficial for individuals of any age group” says Golda Liker, a Nutritionist at New York- Presbyterian Hospital. Many factors are considered before a nutritionist or dietician assigns a diet to any individual. They determine what kind of diet would be appropriate and what it would be comprised of, based on the condition of the client. The uni que patient population found in nursing homes and long term care facilities benefit from a nutritious and balanced diet. The addition of superfoods is advised to significantly improve health for all patients. These facilities update menus and diet plans for each individual client in effort to reduce their current disease progression, improve symptoms, and prevent onset of comorbid diseases. We have listed 8 superfoods recommended for geriatric dietary meal plans, all of which have recently been promoted for their significant nutritional components.

Tofu, a product of fermented soy milk, is high in vegetarian protein, containing all essential amino acids. Tofu helps Blueberries contain antioxidants, dietary fiber and manganese, which helps lower cholesterol levels and activates enzymes necessary for carbohydrate, protein and cholesterol metabolism as well as gluconeogenesis. The anthocyanins that give the berries their rich color, promote memory and brain function. Further, blueberries contain vitamin C, assisting in collagen formation and wound healing.

Quinoa is a whole grain, yet easily digestible, gluten-free, complete protein that naturally contains all essential amino acids. Quinoa is high in iron, vitamin B and potassium, all which assist in blood pressure regulation.

Flax seed/flax seed oil is high in fiber and aids in the prevention of constipation. Flax seed and flax seed oil contain alpha-linolenic acid (ALA), an omega-3 fatty acid that can reduce high blood pressure levels and aid in prevention of cardiovascular disease. Kale, a cruciferous vegetable, is rich in vitamins A, C and K as well as iron, potassium and calcium. As a bile-acid binding vegetable, kale can help reduce the risk of premature degenerative diseases. Note: If the patient is taking a blood thinner, kale is not advised.

Fava beans are a source of protein, fiber, iron, magnesium, potassium, and vitamin B1/thiamin. These components are crucial for proper functioning of the nervous system and necessary for the formation of adenosine triphosphate in energy metabolism.

Salmon contains omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), a vital part of cell membranes which can reduce inflammation and aid in the prevention of cardiovascular disease by reducing blood pressure, heart rate and triglyceride levels.

Grapes are easily accessible, eat to eat fruits. The phenolic compounds in the skin of the grape, commonly associated with red wine, are filled with antioxidants. Properties are beneficial for cardiac health, anti-inflammation and the onset of cancer. When grapes are used topically, they may help prevent enzymes that destroy elastin and collagen in the skin, fighting wrinkles. ●

MAINTAINING MODEL CARE

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WITH INSURANCE BUNDLE PAYMENTS

Upfront Healthcare // September 2016

WAYS TO KEEP CARE UP AS REIMBURSEMENT DROPS

complete intake of the patient’s history and current circumstance. This way there is a complete understanding what the patient’s dynamics, abilities, and constraints are from the beginning, and therapy can be contoured accordingly.

4 Follow Up Legacy Healthcare follows up with patients at 24 hours, 7 and 21 days post-discharge to ensure patient success in home health. This includes making sure home health equipment has been delivered and no complications have arisen.

5 Educate Educate clinical and therapeutic staff that quality of care is always of top importance. Seif tells his staff that “the standard is the standard regardless of the circumstance”. A patient’s education is just as important, especially for their home health experiences. Patients should go Somewhere between 10 and 20 percent of nursing home beds are filled with rehabilitative patients. Recently, there has been increased pressure on hospitals and nursing homes because of the prevalence of Medicare’s bundle payment program.

their segment of costs down. Shua Seif, the Regional Director of Operations for Legacy Healthcare in Skokie, IL, gives us 9 ways that he keeps quality of care up as the level of reimbursement continues to go down.

1 Seamless transitions Bundle payment programs offer a start to finish flat rate payout across the macro rehabilitation umbrella including hospital visit, inpatient facility rehabilitation and home health. Hospitals transfer patients to rehabilitation facilities that are known to have a fast turnaround, keeping

To create a seamless transition from the hospital to rehabilitation facility, Seif recommends a warm handoff from physician to physician. This way there is no time lost in diagnostics or translation and immediate work can begin. The second transition from rehabilitation facility to home health is more dynamic and requires a proper

clinical team to ensure the patient’s ability to navigate their unique home environment.

2 Care Planning The overall goal is to return a patient’s health to prior level of function, so they can go home as soon as possible. Upon admission to a facility, an immediate care-plan should be created, moving all the way through discharge.

3 Full Intake To properly service a patient, the Social Services staff must be sure to have a

home with an understanding of what happened to them and how to avoid the same occurrence in the future.

6 Quality over Quantity With a targeted staff, providing a high level of service is easier to achieve. Fewer practitioners with a higher, more specified skillset, are more beneficial for an efficient organization. “The revenue follows the quality. I believe fully that the world will notice and we will get more business. It has proven true so far” says Seif. In the case of rehabilitative medicine, Legacy Healthcare keeps a physiatrist on staff to create a smooth process directed to the patient’s needs, reaching from length of stay to success in full recovery.

7 Eliminate Non-Care Related Costs To run a tight operation and cut down on unnecessary expenses, look at noncare related costs, eliminate wasteful spending and invest in the right kind of care. Invest into care-related costs to

increase patient volume.

8 Invest in the Right Kind of Care To be more profitable in the long term, providing a high quality of care will be of benefit. Less money might be made per patient, but with a higher quality of care, more patients are enrolled and increased volume is profitable.

9 Organization of Scale The clinical oversight profile of an organization must be able to address diverse patient needs. A large company has the ability to disperse salaries of high level clinicians. Once the umbrella company has grown, top level staff are not pulling salaries from one building, there is more money available to allocate toward employees, better clinicians can be hired, with better treatment and profit following suit. This way resources are gained and the operation becomes leaner. ●

DO MIND Caring For Neurodegenerative Patients

Upfront Healthcare // September 2016

classical pathology, to best treat the patient. The distinctions between care at each stage of the disease progression, should lead to different care by skilled nursing staff. The challenge is not to regiment treatment and have an adaptable staff that can redirect their patients appropriately.

CARING FOR NEURODEGENERATIVE PATIENTS Skilled care for neurodegenerative patients should move beyond basic care; food, shelter and medication- monitoring. After all, half of all Americans after age 80 will develop some degree of dementia.

While the underlying pathology for every case of dementia is similar, personal circumstance causes an individuality within neurodegenerative disease progression that should be viewed in conjunction with the classical pathology to avoid misinterpretation of symptoms. The needs of these patients are a complex combination of psychosocial and medical treatment within a clinical support system. It is vital to keep patients with

Dr. BenMoshe progression, fall prevention should be implemented. Recent innovations have included movement- triggered alarms on beds designed to alert nursing staff that a patient has left their bed, and easily navigable interior design.

neurodegenerative diseases from regressing, by sustaining all types of cognitive stimulation. Danny BenMoshe, M.D., a neurologist at Cedars Sinai Medical Center in Los Angeles, recommends that residents participate in group social activities, and individually challenging mental and physical tasks. Consistent scheduling is very important to establish memory based on routine, dependable social stimulation and lack of paradigm shift in sleep for the patient. Invariable staff assignments allow proper anticipation of the distinct patient’s needs. For patients with severe

Many facilities, like the Richmond Center in New York have found that it is ideal to embed a platform for therapeutic interventions on site after initial diagnosis. Resolutions for platform intervention can comprise of a separate unit or floor for neurodegenerative patients. These areas have higher staff to patient ratios, with training and certifications required. Staff at the Richmond Center, go through a Behavior Intervention Specialist Certification Program (BISCP) teaching applied behavioral analysis. The staff is trained to look at specific behaviors of the individual that manifest through their disease progression rather than relying on

By the same token, antipsychotics should not be used to try to treat behaviors, as the behavior variance for each individual is drastic. Antipsychotics and antidepressants are commonly prescribed for dementia stimulated depression and agitation respectively. However, they are under a black label according to the Food and Drug Administration for an increase in morbidity. These medications must be closely monitored to ensure that there is no progression into cardiac complications, and so comorbidities are not masked. This can often be seen in cases of delirium. It is important to investigate the underlying cause of a delirium state rather than write off the delirium as dementia related agitation. Delirium can be the result of many problems including intestinal infection, low blood sugar, pain and dehydration, says BenMoshe. Through this more complete interpretation and treatment of classical computational neurology, escalation of diseases like dementia may be slowed. ●

HALF OF ALL AMERICANS AFTER AGE 80 WILL DEVELOP SOME DEGREE OF DEMENTIA.

Is Corrective also Protective?

AFTERLASIK Let’s talk about the new geriatric generation of post-Lasik surgery. Lasik, a type of refractive surgery, resets baseline vision, but does not prevent natural vision change over a lifetime. How is this generation aging under their prior Lasik surgery, and what can nursing staff do to assist these patients through it all?

Upfront Healthcare // September 2016

Dr. Michael Savetsky

CATARACTS are most likely

to change vision during aging. More than 60% of Americans have had cataract surgery or have a cataract after age 80, a total of 24.4 million people according to the National Institutes of Health's National Eye Institute. At first, vision is easily correctable with glasses, but once the ability to participate in desired activities is inhibited and glasses can no longer correct the problem,

cataract surgery becomes necessary. As part of cataract surgery, an intraocular lens is implanted, where a lens is placed inside the eye. While there is no extra risk for the procedure itself post refractive surgery, a problem arises in level of correctability. Refractive surgery changes the shape of the cornea. The equipment used to measure the cornea for cataract surgery does not take into account its new postrefractive surgery shape, and therefore presents a standard error in results. This calculation error may cause the patient to require glasses, or there is an option of getting a touch-up refractive surgery procedure afterward. A “common misunderstanding is that Lasik can fix everything. Refractive surgery can only do what glasses and

contacts can do for a patient, so if that doesn’t correct the issue, then it won’t correct with Lasik either” says Michael Savetsky M.D., an Ophthalmologist practiced in New York and Los Angeles. If a patient does choose to get a repeat refractive procedure after cataract surgery, Savetsky recommends photorefractive keratectomy (PRK), instead of Lasik because it is less invasive and works on the surface of the eye instead of lifting up the corneal flap.

“One common misunderstanding is that Lasik can fix everything.” It is important for a nursing staff to be able to recognize the signs of correctable vision loss, like cataracts, and how it distinguishes from irreversible vision loss. While cataracts are eventual to form,

DO’S AND DON’TS OF CATARACT SURGERY Do

Don’t

• Ask questions and address your concerns

• Don’t eat or drink after midnight the night before surgery (including coffee or water)

• Know the available options for lens implants and surgical technique • Take prescribed eye drops prior to surgery, as instructed • Take it easy during the recovery period

• Don’t attempt to lift heavy objects during recovery • Don’t get water in eyes during recovery

recognition is often difficult at early stages and detection is key. Many elderly patients ignore declining vision and interpret the signs as inevitable aging. They often don’t report it or ask for help, so consistent monitoring is increasingly necessary. A good indicator to look for is frustration with reading. An all too common occurrence are patients who claim their vision is fine, but they just cannot read. Patients often also request brighter lights, notice glare or bump into things. Nurses need to recognize the need to refer patients to an ophthalmologist. Staff training programs are available through The Braille Institute and Lighthouse for the Blind. The training provides nursing staff with the proper tools and confidence to provide patients with top quality care. Once vision loss is properly diagnosed by an ophthalmologist, management of the patient’s care can be altered. For reversible vision loss, proper improvement interventions can be chosen, while with irreversible vision loss, tools can be used to enhance the patient’s remaining vision. In the early stages of cataract development, the assumption is that the patient’s vision still allows them to do what they choose. Patients awaiting cataract surgery need to be treated with similar accommodations to those with irreversible vision loss. They can no longer participate in things they want to do, and require nursing staff to maximize their comfort level and safety as much as possible. Recommendations include

providing an easily navigable and open space, increased lighting in rooms, a magnifier, and routine placement of items to increase

accessibility. Some patients may need a referral to a low vision specialist. ●

CLOUDED LENS

IOL

Lasik Surgery Diagram: 1. The cornea before it is cut 2. A corneal flap is cut & opened 3. Laser is used to remove tissue from the center of the cornea to reshape it, correcting refraction 4. Cornea flap is closed and left to heal Cataract Surgery Diagram: Intraocular lens (IOL) implanted in place.

Upfront Healthcare // September 2016

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Upfront Healthcare // September 2016

5 WAYS TO MOTIVATE YOUR NURSING STAFF 1. Don’t punish

Nurses aren’t robots, but we still want them to work like welloiled machines. To keep our nurses happy and productive, we need to make sure they are both motivated and satisfied. Here are 5 ways to implement some of our clinical “best practices” and sustain high levels of motivation.

We all make mistakes. Rather than punishing employees for their errors, let them learn from them. The value of failure is in the lesson learned, not in the punishment. If a nurse was handling a piece of equipment incorrectly and gets called into her manager’s office thinking she will get fired but is instead taught how to properly use the technology, the lesson will be clear and she will surely never make that mistake again.

2. Do recognize good work Give credit where it’s due. Don’t wait until their yearly review to give an employee proper

recognition and appreciation for his or her achievements. Create quarterly reviews or find a way to provide proper kudos in real time. Sometimes a simple gesture of a genuine thank you, such as an email or a cup of coffee, is enough of a motivator. When people receive positive reinforcement and feel appreciated, the demonstrated effect on productivity is powerful (1).

3. Create a positive environment - where stress gets managed To create a positive, stress-free work environment, focus on simple things. Is the work space fresh and clean? Is it happy and colorful or drab and gray? Pay attention to facial structure and body language. Often, negativity can arise not from words themselves, but rather from the manner in which they are conveyed. A simple thank you, a smile, eye contact and a “hello, how are you today?” at the beginning of a shift can make a tremendous difference. Encourage enjoyment and a workspace where nurses want to be, not one where they are counting down the minutes until they can clock out.

It’s hard to create a positive environment without reducing work-related stress. Solve for that problem before it comes up by providing support for issues the second they arise. And stay calm as you work to resolve each problem. If a nurse is assigned to a difficult patient, asking about the patient’s progress can help soothe the situation. Be flexible with breaks during shifts and allow people to take breathers when they feel it’s necessary.

4. Get serious about leadership Engage your staff. Find out what they’re passionate about and encourage them to develop those facets of themselves. Show each team member that you believe in their individual talents, giving them motivation to do their best.

Encourage mentorship between senior and new nurses. Studies show that when people are more involved, they are more energetic, cognitively vigilant and feel more accountability toward measured outcomes (2).

5. Make sure your nurses have room to improve To keep skilled nurses working for you, eliminate the feeling of a deadend job and being undervalued. Instead, create a feeling of moving forward and potential growth on the job. Sixty-five percent of dissatisfied employees indicate feeling undervalued as the reason for their dissatisfaction (3). What potential does their career path have within your organization? Are there opportunities for advancement? Make sure you team feels satisfied with the options that are available to them. ●

Encourage a workspace where nurses want to be, not one where they are counting down the minutes until they can clock out.

Upfront Healthcare // September 2016

SPRX PROMOTION ARTICLE

Upfront Healthcare // September 2016

SpecialtyRx: Making a Move Towards What Matters Exclusive Interview with Brian Napenas, Quality Improvement Manager, on the Exciting Move to SpecialtyRx’s Huge New Facility in New Jersey It’s no secret SpecialtyRx has been growing exponentially for years. What prompted this significant relocation now? In truth, it has been a long time coming. We were totally maxed out as far as space and inventory movement were concerned. But what really motivated us to move was the realization that we simply didn’t have the physical or mental bandwidth to implement new processes to better serve our long term care partners. How did you manage to keep up with demand and meet your renowned delivery schedules while bursting at the seams of your old facility? We went above and beyond, literally. When necessary, staff would work around each other to get the job done, often using free workstations on another floor or department. Even in terms of sheer computing power, we needed at least double the dosage... In what ways are the new facilities enabling you to do more? We always believed that delivering the best customer experience requires a tailored approach to each of our partners. And with four times our previous amount of space, we finally

have the opportunity to create the ultimate internal system to deliver that individualized level of service. Give us a good example. Hmmm, where to start? For one, more desk and elbow space for every team member allows the entire line to be more organized, efficient and effective. More importantly, inter-department connectivity and collaboration becomes innate to the everyday. One thing worth highlighting is our new, highly advanced conveyor platform. We now finally have the space and the wherewithal to create a fully controllable inventory path that’s customizable on the fly. This conveyor belt passes through all mini departments on the pharmacy floor, and we can track and direct any article to any destination at will. The result is that every order passes all checkpoints on the same platform; from the technician’s packaging all through the pharmacist’s final check, its all done right here, the right way, with better oversight than ever before. Talking about oversight, doesn’t a larger facility complicate the process of keeping an eye on delicate inventory? As SpecialtyRx’s resident Quality Improvement Manager, I am personally excited about our new tracking opportunities. This includes everything from receiving to better, safer and easier storage. The receiving area has a huge garage door with a sizeable loading dock so trucks can back up and drop cargo without the need to involve hand delivery.

In addition, our drivers now have their own designated parking area, so they can come and go without playing musical chairs with other employee vehicles. And since we are now in Ridgefield, NJ, we are very close to the Turnpike and can get meds on the move at a moment’s notice—perfect for our 3-hour STAT orders! By all accounts, this move was a serious undertaking. Have you experienced any hiccups? There are always some considerations with projects of this size, and I will admit that we have, for the first time ever, felt overwhelmed. To address any delays or inconveniences to clients, we maintaining direct contact with our partner facilities to know exactly what they need and delivering on it when they need it. I will say this: Adapting to the new space is similar to our everyday commitment to adjust to the times. There will always be something that needs remedying, but helping both people and processes do better is what we do best at SpecialtyRx. So, SpecialtyRx is really moving forward. In more ways than one. Our entire flow is so much better from the moment we receive the meds until they are delivered to facilities. Especially with the plentiful new space, we have the ability to section off OTC drugs from IV packs, etc. Everything gets to the right shelf, and everything is easy to find—including room for improvement.

Upfront Healthcare // September 2016