Taking Healthcare by Storm: Industry Insights with Stephanie McGrath & Sydney Stawarz

In this episode of Taking Healthcare by Storm, Quality Insights Medical Director Dr. Jean Storm speaks with Stephanie McGrath, PharmD,  Executive Director for the Pennsylvania Pharmacist Care Network and Director of Community Partnerships at the University of Pittsburgh School of Pharmacy, and Sydney Stawarz, PharmD,  a Pharmacist Fellow at the University of Pittsburgh School of Pharmacy.  

Stephanie and Sydney discuss their successful collaboration between the Community Pharmacy Enhanced Services Network and Quality Insights to deliver targeted vaccination clinics in long-term care facilities across Pennsylvania. They detail the challenges, successes, and lessons learned from administering almost 5,000 vaccines to nursing home residents.

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website.

Publication number QI-090525-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

 Hello everyone, and welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director of Quality Insights. Today we are diving into a powerful story of collaboration and impact. We're gonna be discussing an innovative partnership between the Community Pharmacy Enhanced Services Network, or C-P-E-S-N and Quality Insights.

Together they helped organize and deliver targeted vaccination clinics in long-term care facilities across. Pennsylvania at a time when protecting vulnerable populations is more important than ever. This effort brought vaccines directly to nursing home residents and staff overcoming barriers and improving public health outcomes.

I just need to say this initiative was so creative in the face of staffing challenges, which all nursing homes across the country are facing. So this initiative really overcame that barrier. We'll explore the successes, challenges, and lessons learned, and explore what is possible for this forward thinking model of care.

I am joined by two fantastic pharmacists. Stephanie Graff, pharm D and Sydney Stawarz Pharm D. So let's get started. Stephanie and Sydney, thank you so very much for joining us today. Thank you, Jean, for having us. Yeah, I'm really excited to talk about this initiative. So can you tell us how you both came to do what you do?

Maybe Stephanie, you could start. Absolutely.  I serve currently as the executive director for the Pennsylvania Pharmacist Care Network, which is the C-P-E-S-N network that you referenced of Pennsylvania, as well as the Director of Community Partnerships at the University of Pittsburgh School of Pharmacy.

But prior to this role, I completed a community pharmacy residency with the University of Pittsburgh in Rite Aid. And then worked for Rite Aid Pharmacy for nearly 10 years, where I started a diabetes education practice and expanded medication therapy management services and provided a lot of vaccine clinics, which is the topic of the discussion today.

My father is actually a retired community pharmacist, but it wasn't until I started working myself in a grocery store pharmacy in high school that I witnessed firsthand the impact that a pharmacist can have on a patient. Pharmacists play an important and often overlooked role in the healthcare system.

And I'm fortunate that my current role allows me to build innovative programs and partnerships with health plans and entities like Quality Insights to allow pharmacists to do what they love, taking care of their communities. That's fantastic that the journey it, you know, really  started from when you were very little Sydney.

 Can you let us know, tell us how you came to do what you do. Yeah   my name is Sydney Stawarz and I am a pharmacist fellow at the University of Pittsburgh School of Pharmacy.  I grew up in Johnstown, Pennsylvania which is where I really started my pharmacy career working at two different local independent pharmacies.

I started as a technician and then became an intern. And through these experiences I learned how pharmacists provide care for their local communities. And the important role that pharmacies have in making sure that patients have access to healthcare and medications especially in rural areas.

So I attended pharmacy school at the University of Pittsburgh and during that time I actually ended up interning with the  Pennsylvania Pharmacist Care Network. Which is really what allowed me to work with community pharmacists across Pennsylvania and learn how community pharmacists can provide services in addition to dispensing medications.

So I graduated from Pitt in 2024 and started my fellowship last July where I've continued to work closely with Stephanie and the PPCN team to really help evaluate different programs where pharmacists provided patient care services. And one of these programs was the PPCN Quality Insights vaccine Initiative where PPCN pharmacists provided vaccines to nursing home residents across Pennsylvania.

 Really excited to be here today. Yeah, I'm excited to talk about it as well.  Can you describe how the collaboration between local pharmacy C-P-E-S-N and Quality Insights came about, and what were the goals at the outset, and how did the partnership evolve over time? Absolutely. The collaboration really started through a national connection made through the Community Pharmacy Enhanced Service Network, or CPSN had already executed a similar program with a different quality improvement organization or QIO in another state.

And they were having good success with it. And you know, we thought here in Pennsylvania  that sounds like a really great idea. You know, could we do that here? And we discovered that quality insights was. The QIO that covered Pennsylvania, and as luck would have it, our team had worked with the Chronic Disease Division through a CDC grant with quality insights for a number of years.

So we already had some connections with quality insights. So we took this idea that worked well in another state and made local connections with the QI team who supported facilities in Pennsylvania  such as Deb Wright, and the program came to life. Initiatives like this can be facilitated at the national or regional level very effectively, but we learned in partnership with Quality Insights and with our pharmacies, they really need to be executed at the local level.

We relied heavily on local relationships and connections to execute the program. Yeah, I think it's really important for people to realize  you know, I had a, during another podcast, someone said, the future is grassroots, and I feel like this illustrates that really well.  At the local level is where you can really make a big impact.

Absolutely. So yeah, what were the, some of the biggest successes of the vaccination clinic initiative in the nursing homes, and were there particular moments or milestones that make you feel like this really worked? Yeah, there were  and reflecting back on it, you know, that becomes so much more clear.

But  we set out to close vaccine gaps. That's what this initiative was all about. So through the, contract with Quality Insights, you know, we outlined which vaccine gaps  were more heavily focused on COVID ID flu,  in particular that the pharmacies really had to focus on working with the facilities to close those gaps.

The numbers are impressive and I'll turn it over to Sydney in just a minute to share her evaluation of the data. But this type of program is very administratively heavy as it relies. And on and requires making connections with the local facilities and the pharmacies and relying on them to coordinate details and conduct clinics in a consistent manner.

And that's not necessarily their top priority at the moment. They are very understaffed generally, and overworked. And, sometimes they just need to, you know, address the problem that's in, in front of them.  and, This opportunity to provide clinics was outside of their normal workflow.  But through our partnership with Quality Insights we were able to match up facilities who were interested in hosting clinics with pharmacies.

To be able to go on site to, to do those clinics.  And I think it was in that first monthly report. So we provided reports to Quality Insights every month.  I think it was after that first report came back that we sat back and thought, wow, this is impressive. And then the numbers of vaccines just kept adding up.

The facilities were very grateful  for, you know, for the most part that's what we heard and the pharmacies appreciated both the business and the clinical opportunity to make a difference in the lives of the facility residents and the staff. But really, I'm going to turn it over to Sydney, who can share the specifics of what she found in the evaluation.

Yeah, so I had the pleasure of actually evaluating the program at the end, which was really  inspiring as new pharmacists. So in the 12 month timeframe, which was between March 1st, 2024 and February 28th, 2025  there were 68 vaccines clinics conducted. At 33 different nursing home locations.  And these were conducted by 19 unique PPCN pharmacies.

So these nursing home vaccine clinics covered 22 counties across Pennsylvania. So through this initiative, we were really able to engage pharmacies and nursing homes all across Pennsylvania. And overall, this initiative allowed for nearly 5,000 vaccines to be administered to nursing home residents across Pennsylvania.

So each PPCN pharmacy administered an average of 260 vaccines or 73 vaccines per clinic. And as for the types of vaccines, Stephanie started to touch on this  this initiative really focused on COVID-19 pneumococcal or pneumonia  and influenza or flu vaccines. But pharmacists also ended up providing some RSV vaccines to residents as well.

And just to kind of talk about the numbers, because I feel like we should call them out there were over 2000 COVID vaccines administered about 1200 pneumonia vaccines administered. Almost 900 flu vaccines administered and about 500 RSV vaccines administered to nursing home residents. So it was really a big success of the vaccine initiative.

And really the result was thousands of vaccines were provided to nursing home residents across Pennsylvania. 5,000 vaccines. Yeah, it's tremendous. I mean, It's really, really amazing That would take nursing home staff a really long time to accomplish that. So  that's a really amazing feat. So what kinds of challenges were faced in organizing and delivering these onsite vaccination clinics and long-term care?

I'm sure there were challenges. And how did the teams work through those challenges? Yeah, so I had the opportunity to work closely with Deb Wright, who was a quality improvement specialist with Quality Insights and a former podcast guest to match up facilities who wanted to host a vaccine clinic with pharmacies who were willing to come on site to do so. as I mentioned, we relied on the local partners to execute the clinic, and both the pharmacies and the. Facilities are often tied up with treating disease. So preventing disease often falls down on the priority list when there's just a limited amount of time in the day. So I think some of our challenges that we experienced were, was just a lack of response from the sites.

You know, but we persisted and were able to successfully match up the facilities who wanted to host a clinic with the pharmacies who were able to come on site with the vaccine to do so. you know, Deb's team even. Went on site at some of the facilities to support the facilities themselves.  The administration of a clinic is, you know, can sometimes be burdensome, you know, because it's, it's layering on top of workflow that already exists  in a facility, in a healthcare environment.

And so this is new work, you know, that's layered on top of that. And so providing some additional staff to go on site and help. Triage and help with just the flow of people  really went a long way.  And I think, you know, communication was just absolutely critical throughout this whole partnership.

 As challenges arose, you know, we talked about it and worked through it and relied again on, on both the facility staff and also the pharmacy staff to help overcome some of those challenges. Yeah, Deb Wright is a fantastic community nursing home initiator. She's just really fantastic in bringing facilities together and, to work together.

So do you have any success stories or meaningful experiences from the program that really stayed with you? Maybe a particular facility or a resident or a moment that captured the impact of the work? We heard from many of our pharmacies, if not all, about their gratitude for this opportunity to be able to, take care of this need that existed in their communities.

In particular there was one pharmacy that went on site to a facility multiple times to provide  different vaccines that the residents needed to the point where now they're continuing, they've developed this relationship.   all of this success, I think just really. Hinges on relationship building and they now have this relationship where the pharmacy outside of this program is going to continue going to the facility to provide vaccines as they need it.

And they figured out, you know, how to do it.  And so I think that just the. ultimate secret to success here is letting local work  and letting that you, you mentioned that grassroots effort, that's the secret sauce in all of this. And so  while we can bring this meaningful opportunity to multiple facilities, multiple pharmacies across the state, as Sydney described.

it's really these, the local folks that we rely on to execute it. And  they did a really beautiful job and we are very grateful that the partnerships will continue beyond the scope of this program. I agree. I think that there's other opportunities even beyond vaccination. So this program required close coordination between pharmacies and nursing homes, two worlds that I know firsthand that don't always work so closely. What lessons did you learn about building and sustaining that kind of partnership? Yeah, I think the greatest lesson is that communication is key.  Deb and her team and I met weekly to talk about the clinics and just, you know, operationally the logistics about making sure that the clinics were covered, that we knew that they were being conducted, that the reporting was occurring and that, any questions and, potential barriers were addressed.

before they became. Larger concerns.  So I think that ultimately what we learned is that if we were able to make a connection between the facilities and the pharmacies, they could continue that partnership.

 They needed to connect to talk about the location, the details, how you know where to park, how many vaccines to bring.  what other considerations that the residents may have. And so, being able to, connect those individuals who were doing the work on the ground was really critical to the success as well.

I. Yeah. So for pharmacists, public health leaders or nursing home staffs, other states or regions looking to replicate something like this, what advice would you offer? Where should they start and what should they watch out for? Yeah. So I can start a little more broad.  Community pharmacies, you know, they're an access point for patients to really receive healthcare.

 And one of the main services offered by pharmacists now are vaccines. And really pharmacists have become experts in vaccine ordering, storage, administration, and education.  they're used to ordering medications, which includes vaccines and pharmacists are familiar with. How do these.

Vaccines need stored. Some you put in the fridge versus some you put in the freezer. Different temperature requirements and documentation of that. Different types of vaccines also have different preparation and administration steps  which pharmacists are really well trained on. So all of that to say there's a lot that goes into conducting clinics, including administrative tasks.

Such as billing, the insurance, coordinating with patients  making sure that vaccine documentation is correct and these are things that pharmacists are used to doing and honestly able to do very well.  So I would say for other regions and states looking to replicate a vaccine initiative like this, I would really recommend working with community pharmacists.

 And I'll turn it over to Stephanie to talk about a little more details with the planning. Yeah, I'll just add that the organized planning and setting goals and expectations was absolutely key to success from expectations from our side at the administrative level to the, you know, on the ground level.

 Absolutely key. We also learned that it was critical to make sure that there was an understanding of how the vaccines were covered and how to bill for them. I think you know, in the healthcare system. We don't always see how money flows for the provision of vaccines. There are covered, preventable services, but somebody pays for them.

And so having an understanding of who pays for them and how and what information is needed in order to bill was absolutely critical. And, those were all things that we had to work through over time and, make sure that the pharmacies had the right information. The vaccines are. Expensive drugs at the end of the day and the program needs to be sustainable.

 So we just needed to make sure that we supported the pharmacies in billing the vaccines correctly  to ensure that they can continue to provide the service. So much involved  and I'll tell you in my research from this podcast, I've just learned a lot about how much pharmacists can do.

 They really need to play more of a clinical role. I think. I think healthcare would improve on the whole, that's just my 2 cents. But this initiative really demonstrated what is possible. So reflecting on the broader role of pharmacies during the pandemic and beyond, how do you see the pharmacist role in long-term care and public health changing in the next few years?

I think that's a loaded question, but I think we can start that. During the COVID-19 pandemic community, pharmacies stayed open  and provided patients with their medications. Vaccines and really any other healthcare need, like COVID-19 testing patients could just walk into a community pharmacy during a time where everything else was closed.

 So the pandemic really allowed for pharmacies to be recognized for their role. In providing services like vaccines. And now most healthcare providers , their offices don't even carry the vaccine products. They're referring their patients to pharmacies to get their needed vaccines. So I'd say one role is that community pharmacists are now the place for people to get vaccinated.

 The pandemic also allowed for pharmacists. And community pharmacies to be recognized for their role in emergency preparedness. And this is one example of how pharmacists role have expanded in the public health space.  Whether the emergency is a pandemic or weather direct disasters like hurricanes or wildfires community pharmacists play an important role in prevention response and the recovery.

To these emergencies.  And this is really because pharmacists bring their expertise such as providing vaccines like during the pandemic or addressing things like drug shortages or triaging. Which really we've been seeing more of over the past few years. You know, during COVID-19 pandemic, the Maui wildfires, and even some of the recent hurricanes  community pharmacists were really part of the emergency response.

Another way that pharmacists role is expanding is through provider status.  So pharmacists nationally are not currently recognized as providers.  But in Pennsylvania.  As of 2024 pharmacists were recently recognized as providers, and this really helps to support the sustainability of services that are within a pharmacist's scope of practice.

 And these are things like medication education evaluation and monitoring of chronic health conditions and vaccine needs assessments. So with shortages of healthcare providers growing like primary care providers and OB GYN. The pharmacist provider status can really play an important role in the delivery of healthcare, which really allows for physicians and other healthcare providers time to take care of the more complex patients.

And lets pharmacists follow up on more of those.  I don't wanna say less, less complex, but yeah, more or less complex patient encounters. I will just say I have reached out to a pharmacist many a time about TPN or Vancomycin dosing, and  those were not at all, I wouldn't consider them less complex, so I appreciate the pharmacists and the role that they play in long-term care.

 I'm excited to see what the future holds. If you had a wishlist for future collaborations like this, whether it's funding, technology, policy changes or partnerships, what would be at the top of the list and why? We always have a wishlist and welcome any future collaboration like this.  It was just really a home run.

 But to improve upon future collaborations, it would be very helpful to have a shared electronic health record. Beyond vaccine history. So pharmacists and other healthcare providers can document to a vaccine registry.  And you can go on and access, providers can go in and access vaccine history.  But beyond that, a shared health information exchange or electronic health record would be.

Much more helpful in closing other care gaps  and even identifying, you know, other vaccines that patients are due for based on their, chronic disease history.  The other item on the wishlist  would be  recognition as providers under Medicare. So pharmacists are not currently recognized as providers under Medicare.

Which is a barrier to being able to bill for services, being able to bill for services allows for sustainability. So our team works on a number of different grant initiatives to pilot innovative work and start programs or jumpstart programs with training and education. But really. Programs need to be sustained over time and a model that's not gonna go away  and not through a grant.

And so Medicare provider status would allow a sustainable provision of patient care services as Sydney described.  What pharmacists can do for Pennsylvania Medicaid recipients. The, world is just so much more broad when you think about Medicare recipients as well and the medication related needs that they have.

  ultimately we'd like to. opportunities like this  more of them to close care gaps, especially those medication related care gaps.  Like vaccines, other chronic disease, medication related care gaps. Our pharmacists are  very effective in doing that.  So I think that, you know, more opportunities like this, we welcome collaborations.

 We appreciate when different people are at the table to provide. Different sets of expertise and skill sets and  really that's the fun part  of what we get to do.   We welcome these types of opportunities and hope that we have many more like these in the future. I agree because this was so successful.

So there should be more of these opportunities in the future. If people want to learn more about the community Pharmacy Enhanced Services Network, C-P-E-S-N, how can they do that? There is a website, www.cpesn.com, that you're welcome to visit. And then our local network, the Pennsylvania Pharmacist Care Network website is pa pharmacist network.com, and you can follow us on social media as well.

We like to highlight some of this great work  some of our pharmacy partners and share some, patient success stories as well. Excellent. We will link that. Stephanie McGrath, Sydney Stawarz. Thank you very much for joining us today. I really enjoyed the conversation. Thank you for having us. Thank you.

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website. We would love to hear from you.

So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.