· Executive Brief
National Pharmacy Week 2026
Recognize the people while reviewing the operating conditions that help them contribute safely and effectively.
Leadership signal
Recognition becomes useful when leaders inspect the real route.
A workforce observance gives leaders a defined point to compare formal role expectations with the work people actually perform. The review can surface invisible coordination, inconsistent escalation, avoidable rework, and tools that require staff to compensate for system gaps.
Start by distinguishing what is known from what the organization still needs to learn. A campaign plan, communication volume, or meeting count does not establish that a route is usable. Leaders need direct listening, clear ownership, locally defined measures, and a method for keeping exceptions visible.
Executive opening
Pharmacy is the medication route the whole system runs on
National Pharmacy Week recognizes the people who keep medications moving through a health system. That movement is easy to overlook until it stops. It stops at a closed storefront, a shortage notice, a discharge without a filled prescription, or an admission where no one had time to take a medication history. This section adds published evidence to the operating guidance above. It stays with access, transitions, safety, workforce and measurement, not individual treatment decisions.
Access is less stable than many leaders assume. Across the contiguous United States, 57.1 million people (17.7%) lived in pharmacy deserts, and another 28.9 million (8.9%) relied on a single pharmacy for access.[10] Openings and closings of U.S. community pharmacies from 2010 to 2023 added up to 86.8% of the pharmacies operating in 2010, about 6.2% a year.[8]
Supply is fragile as well. In national purchasing data from 2017 to 2021, 13.7% of drug supply chain issue reports were followed by a shortage, compared with 4.1% of comparison drugs.[11] Shortages then consume pharmacist time that was meant for other work, a cost one national hospital survey measured in hours and money.[6]
The encouraging finding is that pharmacist-led work changes results when it is aimed well. In one large health system, patients in a pharmacist-led telehealth transitions-of-care program had 30-day readmission of 8.6%, compared with 11.8% among matched nonparticipants.[3] The executive task is to make that work reliable, staffed and measured. Then recognition this week becomes capacity next quarter. The sections that follow show where the evidence is firm, where it is thin, and where leaders will have to measure for themselves.
Pharmacy also sits at the center of several enterprise risks that boards already track. Medication safety, readmission penalties, shortage costs, staff retention and community reputation all pass through the same small set of teams. Treating pharmacy as an operating system, rather than a cost center or a retail partner, is the frame the rest of this brief uses.
Current evidence
What current research shows about access, supply and medication safety
Pharmacy access gaps are large and unevenly spread. The same national analysis found that 4.1 million people (14.3%) in small rural areas depended on a single pharmacy.[10] A separate census-tract study classified 3,105 tracts (3.72%) as pharmacy deserts, home to more than 10 million people.[7] Ownership matters too: turnover from 2010 to 2023 reached 152.7% for independent pharmacies and 49.9% for chains.[8]
Closures do not simply move patients next door. In focus groups with 13 pharmacists and technicians in Colorado and Utah, closures increased prescription volume and operational stress at the remaining pharmacies.[1] Participants also described longer wait times and disrupted continuity of care for patients.[1] Leaders should not judge the effect of a closure by distance alone, especially for people without a car. A closure list is only the start; the useful question is which patients were moved, where, and whether their next refill actually happened.
Shortages reach prescribers as well as pharmacies. In a survey of 96 community oncology practices, nearly 54% were seriously affected by drug shortages in the past 3 months, such as changes to less effective treatments or delays.[5] Each of those changes alters a patient’s plan, which prescribers, pharmacies and patients must then coordinate. In a national survey of Japanese hospitals, 98.1% (214 of 218) of respondents said recent shortages had harmed other hospital pharmacy work.[6]
The safety evidence is strongest at handoffs. A pragmatic controlled trial enrolled 414 general medical patients at a Slovenian teaching hospital.[13] There, pharmacist-led reconciliation with counseling was associated with clinically important discharge medication errors in 9.3% of intervention-ward patients, compared with 61.9% on control wards.[13] Communication design matters as much as staffing. In a randomized trial at a U.S. children’s hospital, 30.4% of caregivers in a health literacy–informed counseling bundle measured an incorrect dose, compared with 54.2% after standard counseling.[15]
Read together, these studies describe a medication route under pressure from several directions at once. Storefronts close, supply chains falter, and handoffs at admission and discharge remain error-prone. Most of the access and shortage evidence is cross-sectional, so it describes exposure rather than proving harm. The safety trials are stronger on design, but each comes from a single setting. Leaders should treat the findings as a map of likely failure points, then confirm them in their own data before setting targets.
Figure 1
Pharmacist-led follow-through changes what happens after the visit
Percent of patients with the stated outcome, as reported in each study. Values are copied from the cited studies [2], [3]; none is estimated.
Data note. The readmission pairs and the medication-fill pair come from two different studies, populations and outcomes, so this is an indirect comparison; compare values only within each pair.
Limitation. The readmission study is retrospective and matched only on age and LACE score; the outreach study was pseudorandomized and found no significant difference in a composite clinical outcome.
Figure data (6 rows)
| Measure | Value | Population, setting and year as reported | Source |
|---|---|---|---|
| 30-day readmission, telehealth transitions-of-care participants | 8.6% | Adults discharged in 2024 from one large health system; 2,253 participants propensity-matched on age and LACE score | [3] |
| 30-day readmission, matched nonparticipants | 11.8% | Same study; matched comparison group | [3] |
| 90-day readmission, telehealth transitions-of-care participants | 16.2% | Same study and participants | [3] |
| 90-day readmission, matched nonparticipants | 20% | Same study; matched comparison group | [3] |
| SGLT2 inhibitor filled within 1 year, pharmacist outreach | 33.5% | 1,476 of 4,400 veterans with chronic kidney disease and type 2 diabetes, 8 VA health systems, 2022 to 2024 | [2] |
| SGLT2 inhibitor filled within 1 year, usual care | 15.5% | 659 of 4,258 veterans in the same study | [2] |
Continuum of care
Transitions are where pharmacy work holds or breaks
Recent readmission evidence includes a retrospective study in a large health system of 116,251 adults discharged in 2024.[3] Of these, 2,253 took part in a pharmacist-led telehealth transitions-of-care program and were matched with nonparticipants on age and LACE score.[3] Readmission at 90 days was 16.2% among participants and 20.0% among matched nonparticipants.[3] The differences were significant for patients with high LACE scores but not for those with low-to-medium scores.[3] For executives, that is a targeting lesson: the same pharmacist hour is worth more when it reaches the highest-risk discharges.
Meds-to-beds programs, which supply medications before a patient leaves, have a fast-growing but uneven literature. A rapid scoping review identified 45 studies, 37 (82%) of them in the United States and 27 (60%) published between 2019 and 2023.[9] In 29 studies (64%), meds-to-beds was the only intervention.[9] Healthcare utilization or system outcomes were examined in 32 studies (71%), while patient clinical outcomes were examined in only 7 (16%).[9] Leaders funding these programs should ask what they will learn, not only how many prescriptions are delivered.
Admission is the other end of the transition. One freestanding pediatric health system described building a pharmacy technician medication history service for patients admitted from the emergency department.[4] The authors also assessed a scoring tool for medication history complexity and reviewed errors assigned by the health system.[4] That design treats the medication history as staffed, measurable work rather than a task squeezed into a busy admission.
Follow-through also extends into ambulatory care. In a quality improvement study across 8 VA health systems, 8,658 eligible veterans with chronic kidney disease and type 2 diabetes were assigned to pharmacist outreach or usual care.[2] Within 1 year, 33.5% of the outreach group had filled an SGLT2 inhibitor prescription, compared with 15.5% of the usual care group.[2] A composite clinical outcome did not differ significantly, with a win ratio of 1.02.[2] Process gains and outcome gains are separate questions, and both belong on the agenda.
The common thread across these studies is ownership of the gap between settings. Errors corrected at discharge can reappear when a community pharmacy fills an outdated prescription. A medication started through outreach can stop when a refill is refused or delayed. The discharge reconciliation trial cited above measured clinically important medication errors at hospital discharge.[13] That list is often where accountability ends. Executives can extend that accountability by deciding who confirms the first fill, who answers the first question, and who hears about the first problem.
Figure 3
Why the pathway breaks
People
- Pharmacist time diverted to shortage management
- Burnout without tested well-being interventions
- Medication histories left to whoever is free at admission
Process
- Pharmacist follow-up not targeted to highest-risk discharges
- Discharge supply without a refill or follow-up check
- Shortage-driven treatment changes not coordinated across prescribers and pharmacies
Technology
- Health system records miss where patients moved after a closure
- No shared view of keystone pharmacies patients depend on
- Digital substitutes unavailable where broadband is weak
Environment
- Pharmacy closures and high independent pharmacy turnover
- Access changes after closures, including transit
- Supply chain disruptions that precede shortages
Policy
- No standard for moving patients after a closure
- Counseling standards that ignore health literacy
- Technician roles not formalized
Measurement
- Indicators dominated by process measures
- Patient experience rarely measured
- Readmission effects not stratified by risk
Unranked qualitative cause-and-effect diagram for the outcome in the box: Patients lose access to medications, or receive unsafe medication information, when pharmacy work crosses a setting or a supply disruption occurs Causes are assembled from the cited literature [1], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [14], [15]; categories are not weighted and their order carries no meaning.
Data note. Qualitative; no frequencies are implied.
Limitation. Causes drawn from published studies may not all apply locally; validate them with frontline teams.
Figure data (6 rows)
| Category | Causes drawn from the cited literature |
|---|---|
| People | Pharmacist time diverted to shortage management; Burnout without tested well-being interventions; Medication histories left to whoever is free at admission |
| Process | Pharmacist follow-up not targeted to highest-risk discharges; Discharge supply without a refill or follow-up check; Shortage-driven treatment changes not coordinated across prescribers and pharmacies |
| Technology | Health system records miss where patients moved after a closure; No shared view of keystone pharmacies patients depend on; Digital substitutes unavailable where broadband is weak |
| Environment | Pharmacy closures and high independent pharmacy turnover; Access changes after closures, including transit; Supply chain disruptions that precede shortages |
| Policy | No standard for moving patients after a closure; Counseling standards that ignore health literacy; Technician roles not formalized |
| Measurement | Indicators dominated by process measures; Patient experience rarely measured; Readmission effects not stratified by risk |
Access
Access depends on storefronts, transfers and a stable supply
Pharmacy access is a network property, not a count of nearby locations. The national pharmacy desert analysis identified keystone pharmacies, the only access point for the people who rely on them.[10] When one of those sites closes, the nearest alternative may be far away or poorly connected to transit. Health systems that know which keystone pharmacies their patients use can plan discharge, refill and outreach routes before a closure, not after it.
Closures also shape where patients end up, often without their choice. Pharmacy staff who lived through closures described longer waits and broken continuity of care for the patients affected.[1] Distance is only one part of that access; transit, opening hours and language services matter as well. Leaders should not assume that patients chose the receiving pharmacy or that health system records reflect the move.
Shortages are an access problem that arrives through the pharmacy counter. Community oncology practices addressed shortages by using alternative drugs (91.5%), stockpiling (87.2%) and developing action plans (84.0%).[5] Patients often meet that change first at the pharmacy, which makes the counter part of the access route. A shortage plan that ends at the purchasing desk leaves the patient conversation to chance. Supply chain warnings do carry signal: drugs with supply chain issue reports were followed by shortages more often than comparison drugs.[11]
Discharge supply is another access lever that health systems control directly. Of the 45 meds-to-beds studies, 21 (47%) examined cost effects or pharmacy operational impacts.[9] That is useful evidence for finance committees, but it says little about whether patients kept taking their medications after the first fill. Executives can pair any discharge supply program with a refill or follow-up check owned by a named team.
Access planning also benefits from looking outward. Community pharmacies sit outside most health system org charts, yet they carry much of the refill, counseling and shortage work that keeps discharged patients stable. A closure or a shortage in one of them can undo an inpatient investment within days. Executives can map the pharmacies their highest-risk patients use, agree on how closure and shortage notices will reach care teams, and review that map at least as often as service line plans. The map should include mail-order and specialty pharmacies as well as storefronts.
Executive guidance · System route
Map the path from first contact to verified follow-through.
Use this route as a discussion framework. Replace each stage with the organization’s approved process, qualified roles, current service capacity, and applicable requirements. Do not infer a clinical protocol from the observance title.
The route at a glance
- See the work
- Clarify the role
- Align role and capacity
- Strengthen handoffs
- Learn with staff
Reliability rule: Every stage needs a named owner, an observable status, an approved escalation path, and a defined signal that shows whether responsibility moved or remained unresolved.
See the work
Map formal responsibilities, actual demand, recurring interruptions, coordination load, and work that arrives through informal channels.
Clarify the role
Align expectations, training, authority, support, and escalation with organizational policy and locally applicable requirements.
Align role and capacity
Compare formal expectations with actual demand, tools, dependencies, backup coverage, and escalation across representative shifts and settings.
Strengthen handoffs
Define what the role sends, receives, acknowledges, escalates, and documents when work crosses a boundary.
Learn with staff
Give the professionals closest to the work a regular voice in reviewing friction, testing changes, and confirming results.
Figure 2
The system route as one flow
The five stages of the system route described in this brief, drawn as one flow with a learning loop back to the start. The stages are the page’s original executive guidance, not a clinical protocol.
Data note. Shows sequence and handoffs only; it carries no counts or rates.
Limitation. Local processes may add, merge or reorder stages under organizational policy.
Figure data (5 rows)
| Stage | What the stage requires |
|---|---|
| See the work | Map formal responsibilities, actual demand, recurring interruptions, coordination load, and work that arrives through informal channels. |
| Clarify the role | Align expectations, training, authority, support, and escalation with organizational policy and locally applicable requirements. |
| Align role and capacity | Compare formal expectations with actual demand, tools, dependencies, backup coverage, and escalation across representative shifts and settings. |
| Strengthen handoffs | Define what the role sends, receives, acknowledges, escalates, and documents when work crosses a boundary. |
| Learn with staff | Give the professionals closest to the work a regular voice in reviewing friction, testing changes, and confirming results. |
Equity and trust
Who loses pharmacy access first
Pharmacy deserts follow older patterns of disinvestment. In the national census-tract study, pharmacy deserts had a higher proportion of Black communities (13% vs 7.6%) and Hispanic communities (19.0% vs 9.5%).[7] Tracts with a high digital divide index had higher odds of being a pharmacy desert, with an odds ratio of 6.94.[7] High residential redlining was also associated with pharmacy deserts, with an odds ratio of 2.18.[7]
That pairing deserves attention from leaders who see mail order and telehealth as the answer to closures. Where storefronts are scarce, digital access may be scarce as well. A substitution strategy that assumes broadband, a smartphone and a stable mailing address will miss the people it is meant to reach.
Rural and transit-dependent patients face a different version of the same gap. In small rural areas, 14.3% of people depended on a single pharmacy.[10] Pharmacy staff reported that closures fell hardest on people without transportation, older adults and patients requiring controlled substances.[1] Independent pharmacies also had much higher turnover than chains over 2010 to 2023.[8] Health systems that track only miles to the nearest pharmacy will not see these patients until they miss a refill. Travel time by public transit is a more honest measure for them.
Trust and comprehension are part of equity too. The pediatric counseling trial enrolled English- and Spanish-speaking caregivers.[15] With the health literacy–informed bundle, 93.4% knew the medication dose, compared with 79.7% after standard counseling.[15] Plain language, demonstration and teach-back are not courtesies. They are controls on a medication route that many families must manage alone once they leave the building.
Equity review therefore needs geography, language and connectivity in the same frame. A pharmacy access measure stratified only by race or payer will miss the transit and broadband barriers that the research links to pharmacy deserts. Leaders can ask community partners which pharmacies people actually use and how they get there. They can also ask whether translated labels and interpreter-supported counseling are available at those sites. The answers will often differ from what internal directories show. Where they differ, the community answer is usually the one patients live with.
Human infrastructure
Pharmacists and technicians absorb strain the system creates
The pharmacy workforce entered recent crises already stretched. A narrative review of U.S. community pharmacists found high rates of burnout and extreme fatigue before the COVID-19 pandemic.[14] The review found no research into interventions or strategies to support well-being or reduce burnout.[14] Organizations therefore cannot buy a proven program off the shelf. They need to remove known sources of strain and test what works locally.
Shortages are one of those sources, and they are measurable. In the Japanese hospital survey, 25.7% of hospitals (219 of 853) answered at least one question.[6] Among responding hospitals, the median time spent managing shortages was 19.5 hours over 32 days.[6] The authors estimated the national annual labor cost at 7.1 billion JPY, about 50 million USD, across 8,110 hospitals.[6] That is pharmacist time not spent on reconciliation, counseling or stewardship.
The strain spreads beyond the pharmacy. Oncology practices seriously affected by shortages more often reported spending substantial resources on them (70.8% v 50.0%), so the work reaches the clinic as well.[5] Every substitution needs a prescriber decision, a pharmacy check and an explanation to the patient. Shortage work is shared work, and it needs a shared owner. Without one, each discipline absorbs its piece quietly and the total cost stays invisible to leaders.
Role design is the most practical response available to leaders. The pediatric medication history service assigned admission medication histories to pharmacy technicians.[4] The multisite transitions program delivered pharmacist follow-up by telehealth across a large system.[3] The VA outreach model paired a mailed letter with a 30-minute pharmacist telephone visit.[2] Each model treats pharmacy expertise as scarce capacity to be deployed deliberately. Each depends on technicians, schedules and information systems that leaders control.
Recognition during this week is most credible when it comes with a visible change in those conditions. That may mean protected time for clinical work during shortage surges, clear technician career steps, or relief from duplicate documentation. The research does not prescribe a single answer, and the burnout literature has not yet tested specific programs. What leaders can do is name the strain, assign an owner, and report back to staff on what changed. Technicians deserve the same attention as pharmacists, because many of the newer models rely on them.
Executive guidance · Operating dashboard
Measure whether the operating route works as intended.
Do not publish a number until the organization defines its numerator, denominator where relevant, owner, source system, exclusions, review cadence, and limits. The candidates below are management prompts, not benchmarks or reported results.
Four operating signals
Each signal pairs an executive question with one candidate local measure, set out below.
Executive guidance · Signal
Role clarity
Are expectations, authority, support, and escalation understood by the role and its partners?
- Candidate local measure
- Locally defined scope questions, misroutes, reassignment, and escalation signals.
Executive guidance · Signal
Capacity resilience
Can the operating model absorb predictable demand and planned absences without unsafe workarounds?
- Candidate local measure
- Coverage gaps, schedule stability, overtime, backlog, and backup activation under local definitions.
Executive guidance · Signal
Role-capacity alignment
Does the operating model match demand while preserving clear role, support, and escalation?
- Candidate local measure
- Locally defined workload, backlog, coverage gaps, reassignment, escalation, and staff feedback.
Executive guidance · Signal
Voice and improvement
Can staff raise concerns and help redesign the work with visible follow-through?
- Candidate local measure
- Improvement ideas, assigned owners, response status, completed changes, and staff feedback.
Figure 4
The operating system behind the dashboard
The four operating signals from this brief’s dashboard, each tied to the candidate owner named in the executive scorecard, around one accountable route. Drawn from the page’s original executive guidance.
Data note. Structural diagram; no measured values.
Limitation. Owners are candidates to be confirmed locally.
Figure data (4 rows)
| Operating signal | Candidate owner |
|---|---|
| Role clarity | Executive sponsor and operational lead |
| Capacity resilience | Operational owner and participating teams |
| Role-capacity alignment | Sending and receiving owners |
| Voice and improvement | Improvement owner and executive sponsor |
Executive guidance · Handoff workflow
Keep work owned when it crosses a boundary.
A handoff is reliable only when the sending party knows who is expected to receive the work, the receiving party acknowledges responsibility, and any unresolved exception remains visible. Local policy and qualified judgment control the actual process.
How responsibility moves
Lane A
From message to accepted ownership
- Confirm the approved message and intended audience.
- Publish the actual entry point and receiving role.
- Acknowledge receipt using the locally approved method.
- Escalate when ownership or response remains unclear.
Lane B
From accepted ownership to verified follow-through
- Record the next accountable owner and visible status.
- State what the role sends, receives, acknowledges, escalates, and documents at each operating boundary.
- Keep unresolved work visible across boundaries.
- Confirm closure or document the continuing exception.
Executive guidance · Executive scorecard
Ask questions that connect intent, ownership, and results.
The scorecard keeps review focused on decisions. Leaders should set definitions locally, examine variation without overclaiming cause, and pair quantitative signals with the experience of people who use and operate the route.
Who reviews what
- Executive sponsor and operational lead
- Operational owner and participating teams
- Sending and receiving owners
- Improvement owner and executive sponsor
Candidate owners named in the scorecard, confirmed locally.
| Operating signal | Executive question | Candidate owner | Suggested review point |
|---|---|---|---|
| Role clarity | Are expectations, authority, support, and escalation understood by the role and its partners? | Executive sponsor and operational lead | At campaign launch and close |
| Capacity resilience | Can the operating model absorb predictable demand and planned absences without unsafe workarounds? | Operational owner and participating teams | At a locally defined cadence |
| Role-capacity alignment | Does the operating model match demand while preserving clear role, support, and escalation? | Sending and receiving owners | At a locally defined cadence |
| Voice and improvement | Can staff raise concerns and help redesign the work with visible follow-through? | Improvement owner and executive sponsor | Until action is verified |
Figure 5
Control points for a reliable pharmacy operating route
| Control point | Risk if missing | Owner | Evidence of control |
|---|---|---|---|
| Keystone pharmacy map for high-risk patient panels | A single closure strands patients who depend on one pharmacy | Chief operating officer with pharmacy and population health leads | Current map reviewed on a set cadence, with closure response plans |
| Closure and prescription transfer notification route | Patients and care teams learn of a transfer only when a refill fails | Pharmacy director and ambulatory operations lead | Share of affected patients contacted and confirmed with a new pharmacy |
| Shortage response with a shared owner | Physicians and pharmacists absorb substitution work separately and invisibly | Chief pharmacy officer with chief medical officer | Shortage log with time spent, substitutions and communications issued |
| Risk-targeted pharmacist transition follow-up | Scarce pharmacist time reaches low-risk patients with little benefit | Hospital medicine and pharmacy transitions leads | Readmission reviewed by risk tier for patients reached and not reached |
| Staffed admission medication history | Errors enter the record at admission and travel to discharge | Emergency department and pharmacy leaders | Completion rate and error review for technician and pharmacist histories |
| Health literacy-informed discharge counseling | Caregivers measure incorrect doses and miss adverse effects | Chief nursing officer and pharmacy education lead | Teach-back documentation and dosing accuracy audits, by preferred language |
| Balanced pharmacy scorecard | Activity counts are reported as impact | Chief quality officer and board quality committee | Process, outcome and patient experience measures reviewed together |
Control points derived from the cited evidence [1], [3], [4], [5], [6], [9], [10], [12], [15] and this brief’s executive guidance.
Data note. Each row is a control to verify, not a measured result.
Limitation. Owners and evidence of control must follow local policy and applicable requirements.
Public communication
Say what the pharmacy route can do, then prove it
How information is delivered changes what people can do with it. In the pediatric trial, caregivers in the health literacy–informed group had a mean dosing error of 1.0%, compared with 3.3% after standard counseling.[15] In the same trial, 78.9% of caregivers in the bundle group correctly reported two or more adverse effects, compared with 18.8% with standard counseling.[15] Public and patient messages during this week can point people to counseling, not just to a phone number.
Communication about closures and shortages is now routine work. Closures can create pharmacy deserts and lengthen wait times at the pharmacies that remain.[1] Most community oncology practices (50.5%) also reported an ethical dilemma related to a drug shortage.[5] Patients need to know where their prescriptions went and how to reach the new pharmacy. Health systems can make those messages consistent across prescribers, pharmacies and patient portals so that no one learns about a change from an empty shelf.
Board communication needs a sturdier evidence base than activity counts. A systematic review of clinical pharmacy indicators for hospital inpatients found 225 proposed indicators across 13 studies.[12] Of those, 85.8% were process measures and only 5.8% were outcome measures, and none came with benchmarking reference values.[12] Patient and caregiver experience appeared in only 11 of 45 meds-to-beds studies (24%).[9] A scorecard built from those habits will report activity well and patient benefit poorly.
The VA outreach study shows why both kinds of measures matter. Pharmacist outreach was associated with increased initiation of the medication, with a hazard ratio of 1.91, yet a composite clinical outcome did not change significantly.[2] Honest reporting of that kind of result builds credibility with clinicians and boards. It also keeps the organization focused on the outcomes patients actually feel.
Public messages this week can be modest and still useful. They can explain what pharmacists and technicians do across the system, how to ask for counseling in a preferred language, and what to do when a pharmacy closes or a medication is unavailable. Each message should match a route that actually works today. Overpromising access that the operating system cannot deliver erodes the trust the observance is meant to build.
Executive guidance · 90-day plan
Move from listening to a verified improvement in 90 days.
The time boxes below are a management framework, not a clinical timeline. Adjust them to risk, scope, governance, resources, stakeholder participation, and applicable review requirements.
Ninety days, three moves
- Days 1–30See the current route
- Days 31–60Build the reliable path
- Days 61–90Make the change visible
Days 1–30 · Listen and map
See the current route
- Name an executive sponsor and an operational owner.
- Listen to people using the route and representative frontline teams.
- Map how National Pharmacy Week communications connect to real entry points, owners, transitions, and escalation.
- Select one recurring barrier that the organization can responsibly address.
Days 31–60 · Design and test
Build the reliable path
- Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal.
- Validate the design with every sending and receiving team involved.
- Ask the professionals closest to the work to select and test one role, tool, workload, or handoff improvement.
- Test the route in more than one representative setting or operating period where practical.
Days 61–90 · Implement and verify
Make the change visible
- Launch the redesigned route with a small set of locally defined measures.
- Review unresolved work and recurring friction using a learning approach.
- Correct implementation barriers and record who owns each remaining dependency.
- Report what changed, what evidence was reviewed, and what still requires live oversight.
Figure 6
The 90-day plan on one timeline
The 90-day plan from this brief drawn as a timeline: each action sits in the 30-day window the plan assigns it. The full wording of each action is in the figure data and in the plan above.
Data note. Time boxes are a management framework, not a clinical timeline.
Limitation. Durations are uniform 30-day windows; real tasks may span windows.
Figure data (12 rows)
| Window | Action |
|---|---|
| Days 1–30 · Listen and map | Name an executive sponsor and an operational owner. |
| Days 1–30 · Listen and map | Listen to people using the route and representative frontline teams. |
| Days 1–30 · Listen and map | Map how National Pharmacy Week communications connect to real entry points, owners, transitions, and escalation. |
| Days 1–30 · Listen and map | Select one recurring barrier that the organization can responsibly address. |
| Days 31–60 · Design and test | Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal. |
| Days 31–60 · Design and test | Validate the design with every sending and receiving team involved. |
| Days 31–60 · Design and test | Ask the professionals closest to the work to select and test one role, tool, workload, or handoff improvement. |
| Days 31–60 · Design and test | Test the route in more than one representative setting or operating period where practical. |
| Days 61–90 · Implement and verify | Launch the redesigned route with a small set of locally defined measures. |
| Days 61–90 · Implement and verify | Review unresolved work and recurring friction using a learning approach. |
| Days 61–90 · Implement and verify | Correct implementation barriers and record who owns each remaining dependency. |
| Days 61–90 · Implement and verify | Report what changed, what evidence was reviewed, and what still requires live oversight. |
Executive guidance · Leadership close
Carry one accountable improvement beyond the campaign window.
Recognition matters. It becomes durable when leaders also listen, clarify the route, support the people operating it, close an identified gap, and report the result without claiming more than the evidence supports.
Leadership commitment
Listen to the people closest to the route, assign one barrier, and verify the change.
Executive action kit · Week observance
Turn National Pharmacy Week into accountable action.
Recognize the people while reviewing the operating conditions that help them contribute safely and effectively.
Leadership focus
Use this observance to examine role clarity, capacity, teamwork, and dependable handoffs. Select one verified barrier, assign an accountable owner, and carry the improvement beyond the campaign window.
Workforce lens
Ask whether staffing, role clarity, training, tools, workload, and escalation support the people operating the role, coverage, workload, and escalation pathway.
Patient and community lens
Make the approved first step clear. Test whether a person can move from information to an acknowledged next action without navigating conflicting instructions.
Equity and access lens
Review whether shift, location, employment status, language, disability, or digital access changes who can use the pathway or receive support.
Five-minute briefing
Inspect the operating sequence
Listen with professionals performing the work, operational leaders, and the teams that depend on them. Find one unclear responsibility, hidden workload, or an unsupported handoff, then test the locally approved route from entry through acknowledged follow-through.
- See the work
- Clarify the role
- Align role and capacity
- Strengthen handoffs
- Learn with staff
Leadership actions for this week
- Name an executive sponsor and frontline operating owner.
- Ask people using and operating the pathway where ownership becomes unclear.
- Test one representative route from first question to acknowledged next step.
- Select one barrier that can be corrected without overstating the evidence.
- Set a review date and define how completion will be verified.
Candidate measures
Define every numerator, denominator where relevant, owner, data source, exclusions, cadence, and limitation locally. These are management prompts, not external benchmarks.
- Locally defined scope questions, misroutes, reassignment, and escalation signals.
- Coverage gaps, schedule stability, overtime, backlog, and backup activation under local definitions.
- Locally defined workload, backlog, coverage gaps, reassignment, escalation, and staff feedback.
Department readiness checklist
- The public and staff entry points match the actual approved process.
- A specific role accepts each request, referral, or escalation.
- Handoffs include acknowledgment and a visible unresolved state.
- Language, disability, digital, transportation, and trust barriers receive explicit review.
- Communications do not introduce unsupported themes, statistics, or clinical advice.
- A named leader will review what changed after the observance.
Intended audiences
- Executive and Operational Leaders
- Nursing and Clinical Leaders
- Workforce and Human Resources Leaders
Staff communication template
During National Pharmacy Week, our organization will connect awareness with a practical review of the role, coverage, workload, and escalation pathway. Use approved information, identify the correct entry point, confirm ownership when work moves, protect privacy, and escalate unresolved barriers through local channels.
Community communication template
National Pharmacy Week is an opportunity to share trustworthy information and make the next step easier to find. Use our approved channels for information and support. If a request changes hands, our goal is to keep ownership and follow-through visible.
Measurement worksheet
- Signal
- What observable condition will show whether the route works?
- Definition
- What is included, excluded, and counted?
- Owner
- Who reviews the signal and acts on exceptions?
- Cadence
- When will leaders review it?
- Equity check
- Which differences require protected, locally appropriate review?
- Closure
- What evidence will confirm the improvement was completed?
- Editorial review
- Completed
- Source records
- 2 listed under Authoritative resources
- Review standard
- Sourced facts remain separated from original executive guidance
- Clinical boundary
- No new statistical or clinical claim was added by this action kit
Sources and content boundary
Authoritative resources
Use note: All operating models, measures, scorecard questions, and action steps are original executive guidance. This article supports leadership planning and education. It does not replace clinical judgment, emergency procedures, legal advice, professional standards, organizational policy, or applicable federal, state, and local requirements.
Peer-reviewed references
References
Fifteen peer-reviewed sources, newest first. Each was individually verified through authenticated academic research databases. Bracketed numbers in the text link here; the original executive guidance on this page carries no citations because it is guidance, not a sourced claim. Sources last checked in those databases on .
- 1.DiStefano MJ, Chen NC, Asche CV, Anderson KE, Mattingly TJ. “The crux of the community”: A qualitative focus group study of the impact of community pharmacy closures in Colorado and Utah. Journal of the American Pharmacists Association. 2026;66(1). https://doi.org/10.1016/j.japh.2025.102940
- 2.Pestka DL, Murphy D, Kaplan AN, Taylor BC, Huynh P, Rechtzigel JA, et al. Pharmacist Outreach and SGLT2 Inhibitor Uptake in Patients With Diabetes and Chronic Kidney Disease. JAMA Network Open. 2026;9(5):e2613081. https://doi.org/10.1001/jamanetworkopen.2026.13081
- 3.Liaw S, Doran CE, Farzadfar D, Ho C, Galla AR, Cha A. Evaluation of a pharmacist-led telehealth transitions-of-care program: A multisite analysis of program impact on readmissions. American Journal of Health-System Pharmacy. 2026:online ahead of print, April 22, 2026. https://doi.org/10.1093/ajhp/zxag111
- 4.Schwaller K, Michel N, Crotty M, Craynon R, Thomas M. Implementation of a pharmacy technician medication history service at a pediatric health system. American Journal of Health-System Pharmacy. 2026;83(Supplement_6):S3033-S3039. https://doi.org/10.1093/ajhp/zxag068
- 5.Ghazal LV, Mohile S, Loh KP, Mustian K, Sventek G, Gada U, et al. Impact of Drug Shortages on Cancer Care Delivery Within the National Cancer Institute Community Oncology Research Program. JCO Oncology Practice. 2026;22(5):834-843. https://doi.org/10.1200/op-25-00057
- 6.Yasui T, Takase T, Ueno H, Kiko Y, Yamamuro F, Nakashima T, et al. Impact of drug shortages on the work of hospital pharmacists in Japan. Journal of Pharmaceutical Policy and Practice. 2026;19(1):2602285. https://doi.org/10.1080/20523211.2025.2602285
- 7.Catalano G, Woldesenbet S, Pawlik TM. Distribution of pharmacy deserts and its association with digital divide and residential redlining across the United States. PLOS ONE. 2025;20(8):e0330027. https://doi.org/10.1371/journal.pone.0330027
- 8.Mattingly TJ II, Sahu M, Anderson KE. Community Pharmacy Turnover and Context of Openings and Closings by Ownership Type. JAMA Health Forum. 2025;6(8):e251988. https://doi.org/10.1001/jamahealthforum.2025.1988
- 9.Muir A, Rodriguez MC, Kang SC, Abdoulrezzak R, Schneider T, Borras J, et al. Provision of medication supply at hospital discharge: A rapid scoping review of the “Meds-to-Beds” care model. American Journal of Health-System Pharmacy. 2025;83(3):e105-e114. https://doi.org/10.1093/ajhp/zxaf151
- 10.Mathis WS, Berenbrok LA, Kahn PA, Appolon G, Tang S, Hernandez I. Vulnerability Index Approach to Identify Pharmacy Deserts and Keystone Pharmacies. JAMA Network Open. 2025;8(3):e250715. https://doi.org/10.1001/jamanetworkopen.2025.0715
- 11.Callaway Kim K, Rothenberger SD, Tadrous M, Hernandez I, Gellad WF, Devine JW, et al. Drug Shortages Prior to and During the COVID-19 Pandemic. JAMA Network Open. 2024;7(4):e244246. https://doi.org/10.1001/jamanetworkopen.2024.4246
- 12.Magedanz L, Silva HL, Galato D, Fernandez-Llimos F. Clinical pharmacy key performance indicators for hospital inpatient setting: a systematic review. International Journal of Clinical Pharmacy. 2024;46(3):602-613. https://doi.org/10.1007/s11096-024-01717-x
- 13.Jošt M, Kerec Kos M, Kos M, Knez L. Effectiveness of pharmacist-led medication reconciliation on medication errors at hospital discharge and healthcare utilization in the next 30 days: a pragmatic clinical trial. Frontiers in Pharmacology. 2024;15:1377781. https://doi.org/10.3389/fphar.2024.1377781
- 14.Wash A, Moczygemba LR, Brown CM, Crismon ML, Whittaker TA. A narrative review of the well-being and burnout of U.S. community pharmacists. Journal of the American Pharmacists Association. 2024;64(2):337-349. https://doi.org/10.1016/j.japh.2023.11.017
- 15.Carroll AR, Johnson JA, Stassun JC, Greevy RA, Mixon AS, Williams DJ. Health Literacy–Informed Communication to Reduce Discharge Medication Errors in Hospitalized Children: A Randomized Clinical Trial. JAMA Network Open. 2024;7(1):e2350969. https://doi.org/10.1001/jamanetworkopen.2023.50969
Claim-to-source matrix
What each source supports
Every sourced claim in the new sections maps to the references that support it, the section where it is used, and the limitation a reader should keep in mind. Original executive guidance carries no sources because it is guidance, not a finding.
| Claim group | Sources | Years | Used in | Limitation |
|---|---|---|---|---|
| National pharmacy desert prevalence, single-pharmacy dependence and keystone pharmacies | [10] | 2025 | Current evidence | Cross-sectional geospatial analysis of the contiguous United States; desert definitions depend on travel-time thresholds. |
| Pharmacy deserts associated with digital divide and residential redlining | [7] | 2025 | Equity and trust | Cross-sectional census-tract associations; not causal; tract-level rather than individual data. |
| Community pharmacy turnover by ownership type, 2010 to 2023 | [8] | 2025 | Current evidence | Counts openings and closings; does not measure patient outcomes or service quality. |
| Effects of community pharmacy closures on pharmacy operations, staff and patients | [1] | 2026 | Access | Qualitative focus groups with 13 pharmacists and technicians in two states; staff perspectives only, not patient-level outcomes. |
| Supply chain issue reports and subsequent drug shortages | [11] | 2024 | Current evidence | U.S. purchasing data 2017 to 2021; association between reports and shortages, not shortage impact on patients. |
| Drug shortages and cancer care delivery in community oncology practices | [5] | 2026 | Access | Practice-level survey of 96 community oncology practices with a 3-month recall window; oncology findings may not generalize to other services. |
| Pharmacist time and labor cost spent managing drug shortages | [6] | 2026 | Human infrastructure | Japanese hospitals; 25.7% response; cost is a national extrapolation. |
| Pharmacist-led telehealth transitions of care and 30- and 90-day readmission | [3] | 2026 | Continuum of care | Retrospective, propensity-matched on age and LACE score only; single health system; residual confounding possible. |
| Scope and outcome focus of meds-to-beds studies | [9] | 2025 | Continuum of care | Rapid scoping review; describes what was studied, not effect sizes. |
| Pharmacy technician medication history service at admission | [4] | 2026 | Continuum of care | Single pediatric system implementation report; abstract figures internally inconsistent and not cited. |
| Pharmacist outreach, medication initiation and clinical outcomes | [2] | 2026 | Continuum of care | Pseudorandomized quality improvement study in 8 VA health systems; mostly older White men. |
| Pharmacist-led reconciliation and clinically important discharge medication errors | [13] | 2024 | Current evidence | Pragmatic controlled, not individually randomized, trial at one Slovenian hospital. |
| Health literacy-informed discharge counseling, dosing errors and caregiver knowledge | [15] | 2024 | Public communication | Single U.S. children’s hospital; liquid medications for children 6 years or younger; English- and Spanish-speaking caregivers. |
| Burnout and well-being of U.S. community pharmacists | [14] | 2024 | Human infrastructure | Narrative review; community pharmacy only; no tested interventions identified. |
| Clinical pharmacy key performance indicators are mostly process measures without benchmarks | [12] | 2024 | Public communication | Inpatient hospital indicators only; 13 studies. |
About the author
Greg Wahlstrom
MBAHCM
President and Chief Executive Officer, The Healthcare Executive
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