Creating a Specialty Pharmacy in a Space-Challenged Hospital Campus

Building a specialty pharmacy within a hospital or health system offers many benefits such as convenience, accelerated growth, improved patient access to innovative medications, and enhanced patient care and clinical outcomes. The proximity of a specialty pharmacy to a hospital or health system helps to simplify the care journey and reduce care fragmentation, while keeping the long-term care of the patient fully managed by their care team. Yet, many hospitals and health systems hesitate or delay building their own specialty pharmacy because they believe they lack the space.

Creating a specialty pharmacy in a space-challenged hospital campus can seem like a daunting task, particularly in a crowded metropolitan or suburban area. However, there are creative solutions to solve for this barrier, allowing more hospitals and health systems to offer a vital service line that improves equitable access to medications and clinical support for their patients on specialty medications. Here are three important tips hospitals and health systems can follow when planning for a specialty pharmacy in a space-challenged campus. 

1. Ensure expertise is in place at the beginning of the planning stage: Setting a specialty pharmacy up for success happens at the beginning stages of planning for the build. A team of operation and pharmacy build experts can help to determine the best location, layout, technology and design and will oversee the overall operation of the pharmacy build to verify that it flows as efficiently as possible. Many hospitals and health systems turn to outside operation and pharmacy build experts to help them plan and decipher the construction of a new specialty pharmacy. A tour of the campus and a planning session can help to zero in on possible locations for the pharmacy build. 

2. Consider pharmacy operation needs: Once a specialty medication is prescribed, prior authorization is often required for approval, and there is often a co-pay. The process for getting medication initially approved and paid for can take up to two or more days, so most patients are not actually standing in line at the pharmacy after their appointment. Most patients on specialty medications typically have medication delivered to their home, so finding a location that can incorporate mail order accommodations will be an important consideration. Taking workflow into account can also help to reduce the necessity of finding a space at the hospital with an attractive store front. Many hospitals and health systems do not have an adequate footprint for this type of space, and being flexible in finding the right location can open opportunities for growth.

3. Find creative solutions for space: While it is ideal to have a store front location for a specialty pharmacy space, there is opportunity for flexibility in determining the appropriate space. Finding creative ways to incorporate retail pharmacies within specialty pharmacies in these flexible spaces has become an important part of the planning process. Specialty pharmacies and retail pharmacies are being successfully constructed and operated in unique locations, never thought possible, such as an above ground floor, basement, office park or storage facility.

Important optimization workflow and design considerations

A specialty pharmacy that has an optimized workflow and design will better support the long-term needs of the clinical staff, pharmacists and patients and will enable the pharmacy to gain access to innovative limited distribution medications through earning accreditations when the pharmacy is up and running. Earning accreditations, such as URAC and ACHC, demonstrate that pharmacy operations and patient management services adhere to the highest set of standards. Careful and effective planning for the build and design of a specialty pharmacy upfront helps to eliminate any barriers and will make compliance and accreditation a smooth process.

Here are a few other areas to consider and pay careful attention to when building a specialty pharmacy.

Schematic design layout considerations

1. Consultation area: Private space needed for medication review and training with patients.
2. Waiting area: Public waiting area for prescriptions to be filled; wi-fi is ideal in a modern waiting area.
3. Point of sale: Counter space where patients drop off or pick up their prescriptions.
4. Data entry: Area where staff can enter prescription information, make patient phone calls, undergo the insurance claim adjudication process and speak to prescribers.
5. Production inventory: The primary fulfillment area that also includes casework and shelving, as well as all refrigerated and controlled drug storage.
6. Packaging and shipping: Area where medications are packaged and delivered.
7. Loading and receiving: External-access space for incoming deliveries from wholesalers and vendors are delivered and outgoing patient deliveries are picked up.

Other considerations include determining whether the pharmacy will require a manager’s office, breakroom/lockers, staff restroom, storage room, compounding area, functional sink with hot and cold water or an eye wash station, equipment such as refrigerators and freezers and a backup generator.

Sometimes overlooked details for a specialty pharmacy build

1. Casework and shelving: Determine the minimal quantities needed based on projected prescription volume and optimal placement.
2. Furniture and fixtures: Select the type, quantity and placement.
3. Data and power: Choose the technology and equipment needed, and the power and data required to support it.
4. Security features: Plan out the features needed to keep the pharmacy safe such as cameras, card readers, motion sensors and alarms, glass sensors where needed as well as alarm activation and deactivation.
5. Signage and postings: Coordinate in conjunction with the hospital’s marketing and branding department.

Planning for the build and layout of a specialty pharmacy is a team effort and one that requires careful planning, creative solutions for finding space and a deep understanding of the operational, compliance and accreditation requirements. More health systems can build specialty pharmacies and improve growth and financial stability through working with a specialty pharmacy partner that can implement these steps successfully. The planning and design of a specialty pharmacy when carefully and meticulously designed and constructed supports a hospital’s or health system’s future growth, ensures compliance, optimizes care and builds a legacy for the future.

Photo: Paul Bradbury/Getty Images

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