WHAKAMANA WHĀNAU: GROWING A CULTURALLY REPRESENTATIVE HEALTH WORKFORCE THROUGH COMMUNITY LED PATHWAYS
European Statement
Introductory Statements and Governance
Author(s)
Greasley CE Christchurch Hospital, Christchurch, New Zealand clare.greasley@cdhb.health.nz
Why was it done?
Māori and Pasifika peoples are significantly underrepresented in New Zealand’s health workforce, particularly in Canterbury, where Māori make up 12% of the population but only 5% of the health workforce. In pharmacy we recognised the lack of diversity across our staff groups and were excited to participate in Whakamana Whānau, an initiative by Health New Zealand Canterbury aimed to address inequities by creating accessible pathways into health sector employment for Māori and Pasifika.
Whakamana Whānau exemplifies Statement 1.5 by building a diverse, sustainable and community rooted hospital pharmacy workforce to address equity gaps and optimise patient outcomes.
What was done?
Our pharmacy participated in a novel programme developed by our organisations recruitment department which aimed to:
• Increase Māori and Pasifika representation in the health workforce
• Provide whānau-centred support for sustainable employment
• Facilitate progression from non-clinical to clinical roles
• Strengthen workforce retention and community connection to health services
How was it done?
Whakamana Whānau recruited participants through community networks and educational institutions, placing them in non-clinical roles such as assistants, ward clerks, and orderlies, with tailored pastoral and educational support. They received mentoring, cultural guidance, and career pathway support.
Pharmacy staff attended community sessions to support strength-finding exercises and answer questions to help participants find well matched roles. Short, informal interviews were conducted to help select applicants.
What has been achieved?
Pharmacy successfully participated in two recruitment programmes employing two assistants. Using a culturally grounded, supportive model we reached individuals that would never have applied using conventional recruitment processes.
Over three recruitment programmes the programme employed 80 Māori and Pasifika staff with a 93% retention rate. Some participants have since progressed into study for roles including nursing and medical imaging. Anecdotal evidence showed strong secondary uptake, with friends and family applying for subsequent intakes.
Whakamana Whānau demonstrates the power of culturally grounded, community-led employment pathways in addressing longstanding health workforce inequities. It delivers measurable outcomes in diversity, retention and fostering of intergenerational change through whānau engagement.
What next?
The success of Whakamana Whānau shows what’s possible when we think differently. Pharmacy has the opportunity to think differently around recruitment to ensure diversity, equity, and inclusion part of the everyday fabric of our workforce.
IMPLEMENTATION OF A MULTIDISCIPLINARY COMMITTEE FOR BIOLOGICAL THERAPIES IN AIRWAY DISEASES AND THE ROLE OF THE HOSPITAL PHARMACIST
European Statement
Introductory Statements and Governance
Author(s)
Nonia Ferreras López, Irene de la Fuente Villaverde, Blanca de la Nogal Fernández, Virginia Martínez Fernández, Eva Martínez Álvarez, Zulema Rodríguez Fernández, Henar García Lagunar, Raúl Martínez, Miriam Rodríguez María.
Why was it done?
A Multidisciplinary Biological Therapy Committee for Airway Diseases (BTCAD) was established in a secondary-level hospital. The committee integrated pulmonologists, ENT specialists, allergists, pathologists, and hospital pharmacists (HPs) to optimize the use of biological therapies (BTs). Its main functions included patient evaluation, development of consensus-based protocols, and structured monitoring of treatment outcomes.
What was done?
The initiative was introduced in 2022 to address the absence of standardized decision-making processes for BTs in severe uncontrolled asthma and chronic rhinosinusitis with nasal polyps. Prior to implementation, therapeutic selection was fragmented and lacked uniform criteria. The primary aim was to improve appropriateness of BT use, reduce variability in clinical practice, and ensure optimal patient outcomes through a coordinated multidisciplinary approach.
How was it done?
The BTCAD defined clinical and laboratory criteria for patient selection, developed a consensus document for BT positioning, and designed workflows for dispensing and follow-up. Monthly meetings were held to evaluate cases, supported by a shared calendar and a structured database. Educational sessions were organized to update staff knowledge. Obstacles included the requirement for strong managerial support and the impact of staff turnover on continuity. These were mitigated by formalizing procedures and ensuring standardized documentation and training.
What has been achieved?
From March 2022 to March 2025, 54 patients were assessed: 49 with severe asthma and 5 with chronic rhinosinusitis with nasal polyps. Treatment was discontinued in two cases due to lack of efficacy, and seven patients were switched to alternative BTs. At follow-up, 52 patients remained on therapy (17 benralizumab, 20 mepolizumab, 7 omalizumab, 6 dupilumab, 2 tezepelumab). The HP contributed to patient evaluation, drafting of reports, pharmacovigilance, and adherence monitoring. A survey revealed that all members reported increased knowledge, 87,5% considered the pharmacist’s role essential, and overall satisfaction reached 4,38/5.
What next?
The BTCAD improved coordination, standardization, and professional development within the hospital. Its model is transferable to other healthcare settings, providing a framework for safe and efficient BT implementation. The high satisfaction and demonstrated value of multidisciplinary collaboration, particularly the HP’s role, support its consideration as an example of good practice.
WHEN CRISIS BECOMES COLLABORATION: A NATIONAL RESPONSE TO COMPOUNDED MEDICINES SHORTAGES
European Statement
Introductory Statements and Governance
Author(s)
F.H. Nielsen
A.G Pedersen
L. Jensen
M. Kristoffersen
P. Stoffersen
T. P Dahl
Why was it done?
The shutdown significantly increased the risk of shortages for 271 compounded medicines, many vital for specialised treatments. To secure patient safety and equal access, a coordinated national approach was required to mobilise production capacity and set priorities. Due to the short shelf life of compounded medicines, it was crucial to establish a rapid national response to prevent critical shortages.
What was done?
Following the sudden shutdown of a compounding pharmacy, a national response was initiated. A joint online platform was established between the National Group for Compounded Medicines and the National Task Force for Medicine Shortages, both composed of representatives from hospital pharmacies. This platform consolidated data and decisions, ensuring planning through a national perspective. Based on the merged data, production was coordinated between remaining compounding pharmacies, both public and private, to ensure supply.
How was it done?
An online platform was established to track stock levels across hospital pharmacies, and clinical criticality was assessed on a 1–3 scale visualised with a colour code showing national coverage in days or weeks. Oral solutions with short shelf life were identified as top priority due to imminent stock depletion. Each product was reviewed for possible substitution, therapeutic alternatives, or justification for compounding. Short-term measures included extemporaneous preparation, while long-term strategies involved outsourcing, substitution, and redistribution of stock. Regular national meetings ensured the remaining two compounding pharmacies developed joint production plans, distributing workload and adjusting capacity.
What has been achieved?
This initiative demonstrates how hospital pharmacies, through national collaboration, can ensure resilience in crises. Within two months, nearly all medicines were reintroduced, substituted, or outsourced, and supply maintained without major safety incidents. The national approach included both public and private pharmacies, and their collaboration was strengthened.
What next?
The model provides a transferable framework for future shortages, proving that collaboration, shared data, and prioritisation tools can ensure patient safety and equity of access. The same model has since been applied to other critical shortages, confirming its broader value.
CYBER RISK ANTICIPATION: HOW TO GET YOUR HOSPITAL PHARMACY PREPARED IN (ALMOST) 2 HOURS?
European Statement
Introductory Statements and Governance
Author(s)
C. Delage1, P. Troude2, U. Gouot3, V. Bloch1, B. Isabey4, A. Desmons5.
1 Pharmacy Department, Lariboisière-Fernand Widal Hospital, GHU APHP.Nord, Assistance Publique – Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 PARIS
2 Public Health Department, Lariboisière-Fernand Widal Hospital, GHU APHP.Nord, Assistance Publique – Hôpitaux de Paris, 200 rue du faubourg Saint-Denis, 75010 PARIS
3 Information Systems Department, Lariboisière-Fernand Widal Hospital, GHU APHP.Nord, Assistance Publique – Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 PARIS
4 Hospital Executive Management, Lariboisière-Fernand Widal Hospital, GHU APHP.Nord, Assistance Publique – Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 PARIS
5 General Affairs Department, Lariboisière-Fernand Widal Hospital, GHU APHP.Nord, Assistance Publique – Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 PARIS
Why was it done?
With the 2024 Olympic Games approaching, French healthcare institutions faced an elevated cyberattack risk. Preparing healthcare services for such events is essential but often time-consuming, leading sometime to postpone or abandon this work. A rapid, pragmatic methodology was therefore needed to efficiently assess vulnerabilities and define concrete preparedness measures without overburdening teams.
What was done?
A fast-track business continuity plan (BCP) approach was developed by the management department of our university hospital and implemented in the pharmacy department to rapidly assess preparedness for cyber risks and IT disruptions. The structured process mapping allowed each sector to produce an operational continuity plan in only a few hours, evaluating process vulnerability, defining measures to maintain operations during a cyberattack, and identifying needs (new IT equipment, human resources, backup materials).
How was it done?
Dedicated meeting (1-4 hours) were held for each pharmacy sector (medicines, medical devices, sterilisation, radiopharmacy), involving the cyber risk pharmacist referent and sector head. The plan took the form of a table describing all sector processes (eg., procurement, storage, dispensing), their normal functioning and IT requirements (applications, devices, networked medical equipment…). Subsequent columns described degraded functioning and required resources (staff, equipment, premises) at three time horizons: 3 hours, 3 days, and 3 weeks after the start of a cyberattack.
What has been achieved?
Nine BCPs identified 64 processes. In just a few hours, the method provided a clear picture of which sectors/processes were resilient and which were unprepared. It revealed vulnerabilities such as reliance on IT systems and automation, lack of printed procedures, and absence of backup equipment. Simple measures were identified to improve preparedness: printing key documents (eg. hospital formulary), identifying critical data for regular backup, training staff, etc. This rapid diagnostic approach raised awareness among hospital management of resources needed to sustain pharmacy operations during cyber disruption.
What next?
Based on their BCP, each sector took measures to get prepared to IT shutdown. Using professionals’ deep process knowledge to design practical solution to ensure continuity of clinical activity makes preparedness for IT disruption more accessible. Given its simplicity, the methodology was generalised by hospital management to all departments.
RATEC PLATFORM: A REGIONAL DIGITAL SYSTEM FOR THE REQUEST PURCHASE AND HEALTH TECHNOLOGY ASSESSMENT OF MEDICAL DEVICES AND AND IN VITRO DIAGNOSTICS
European Statement
Introductory Statements and Governance
Author(s)
E. Santarossa, F.F. Faccioli, L. Dal Cin, M.C. Libralato, M. Saia, A. Cavazzana
Governo Clinico, Azienda Zero, Padova, Italy
elisabetta.santarossa@gmail.com
Why was it done?
In Italy, regions frequently fail to comply with the spending cap for medical devices (MDs) and in vitro diagnostics (IVDs). Guided by the principles of Regulation (EU) 2021/2282, the RATEC platform employs HTA to facilitate timely access to innovation, promote efficient resource allocation through uniform HTA criteria, and foster collaboration among healthcare organizations (HCOs) to avoid duplicative assessments.
What was done?
The RATEC platform digitizes the regional process for the request and health technology assessment (HTA) of new MDs and IVDs. It was developed within the framework of the NET 2018-12368077 ministerial program, funded by the Ministry of Health and the Veneto Region.
How was it done?
The process starts with the healthcare professional completing a specific form (Non-Urgent MDs/IVDs, Urgent MDs/IVDs, Biomedical Equipment,). After validation by the head of the department, the request is evaluated by the Multidisciplinary Hospital Unit for MDs/IVDs assessment (called UVA-DM). RATEC provides to UVA-DM an HTA methodology with a clearly defined PICO (Population, Intervention, Comparator, Outcome) and includes a Multi-Criteria Decision Analysis (MCDA). The model graphically displays the evaluation outcome (Y: Value, X: Risk) and suggests a decision orientation: innovative technologies for central reporting, technologies to be approved or technologies to be rejected. Technologies defined as innovative are forwarded to the central phase for HTA reports, which will be available to all regional HCOs.
What has been achieved?
By October 2025, 1054 MDs/IVDs purchase requests had been submitted to RATEC, with 695 evaluated by UVA-DM and 13 reaching the central phase for the HTA report. The approved requests are estimated to have an economic impact of € 4,181,740, excluding biomedical equipment. From 2025 onwards, all regional public HCOs must use RATEC for evaluation of MDs/IVDs.
What next?
The RATEC platform is not only a tool for regional governance but a scalable digital infrastructure that fosters transparency, equity, and value-based decision-making in healthcare. Its continuous enhancement aims to expand the model beyond regional borders, positioning RATEC as a best practice for integrating HTA into procurement processes and ensuring rapid, sustainable access to innovation.
IMPLEMENTATION OF A STRUCTURED PHASE-OUT OF DESFLURANE TO REDUCE THE ENVIRONMENTAL IMPACT OF ANAESTHESIA IN A UNIVERSITY HOSPITAL
European Statement
Introductory Statements and Governance
Author(s)
Federica Pieri, Barbara Crivelli, Beatrice Faitelli
Why was it done?
Desflurane is an inhalational anaesthetic agent with an extremely high global warming potential (GWP100 ≈ 2,540), representing a major contributor to greenhouse gas emissions from operating theatres. The 2024 European F-gas Regulation mandates a progressive phase-out of fluorinated gases, including a complete ban on desflurane from January 2026. In anticipation of this regulation, our hospital sought to reduce its environmental impact by eliminating desflurane use and promoting more sustainable anaesthetic techniques.
What was done?
A multidisciplinary sustainability programme was launched to achieve complete phase-out of desflurane by December 2025, replacing it with sevoflurane and total intravenous anaesthesia (TIVA) using propofol. The goal was to maintain clinical effectiveness and patient safety while engaging anaesthetists in environmentally responsible practices.
How was it done?
A task force composed of Pharmacy, Anaesthesiology, Biomedical Engineering and Environmental Safety departments developed a structured plan that included:
Baseline assessment of desflurane, sevoflurane, and nitrous oxide consumption; Educational sessions on environmental impact and low-flow anaesthesia (<1 L/min); Gradual removal of desflurane vaporizers from operating theatres; Monitoring of TIVA adoption and evaluation of gas-scavenging systems. Environmental impact was quantified as CO₂ equivalent (CO₂e) using GWP100 factors (Desflurane = 2540, Sevoflurane = 130, N₂O = 298).
What has been achieved?
Between 2024 and 2025, desflurane use was reduced by more than 85%, replaced by sevoflurane and TIVA. This resulted in an estimated >80% reduction in anaesthetic gas-related CO₂ emissions, equivalent to several tonnes of CO₂ avoided annually. No adverse clinical outcomes were observed and staff feedback highlighted increased awareness and acceptance of environmentally sustainable practices.
What next?
The next steps include full desflurane disposal by December 2025, continuous monitoring of sevoflurane and TIVA use and expansion of the sustainability programme to other anaesthetic and perioperative practices. This structured approach demonstrates the pivotal role of hospital pharmacists in climate-conscious healthcare and provides a replicable model for other institutions preparing for the 2026 EU ban.
STRUCTURED INNOVATION GOVERNANCE: AN INTERPROFESSIONAL COMMITTEE IN HOSPITAL PHARMACY
European Statement
Introductory Statements and Governance
Author(s)
Vanusa Barbosa Pinto, Cleuber Esteves Chaves, Andréa Cássia Pereira Sforsin, , Priscila Faria França, Mayara Araújo Dias, Erik Magnus Lindh, Caroline Sandoli de Almeida Souza, Maria Cleusa Martins, Maristela Barros De Sousa, Rafael Alves de Souza,
Why was it done?
We implemented a structured, interprofessional Innovation Committee within the hospital pharmacy to systematically manage the entire innovation pipeline. The team, comprising pharmacists, nutritionists, physicians, and Information Technology (IT) specialists, established a formal process to guide high-potential projects from initial ideation to final submission for competitive funding. This governance model was successfully applied in 2025 at the pharmacy of a public teaching hospital.
What was done?
Innovation often lacks strategic coordination in hospital pharmacy, limiting the translation of valuable ideas into robust projects. Our objective was to overcome this unstructured environment by creating a governance framework. The committee began its work by specifically focusing on identifying deep clinical “pain points,” such as fragmentation in antimicrobial management, difficulty in customizing medication dosages, and low adherence to training programs for Generation Z staff.
How was it done?
Projects were prioritized based on a methodology that weighed clinical impact, economic feasibility, and technical executability. The team utilized agile management tools, including the value-versus-effort matrix and the problem-solution canvas, complemented by sprint rituals to ensure progress and alignment. The committee successfully generated and developed three large, scalable proposals, validating the model’s capacity to identify and mature high-impact ideas. These proposals were submitted to a competitive institutional innovation grant (In.Cube-InovaHC).
What has been achieved?
The structured process resulted in a robust innovation pipeline with three high-potential proposals: PrintPharma (3D-printed personalized medications), FarmáciaLab (a gamified platform for team training), and Sentinela-ATB (an antimicrobial stewardship hub). The PrintPharma project, which aimed to develop an in-hospital 3D printing solution for personalized medicines, was ranked 8th among 134 highly competitive proposals in a major institutional innovation grant (In.Cube-InovaHC). This ranking validated the quality and maturity of the committee’s output.
What next?
This structured, pharmacy-managed innovation pipeline is a feasible and high-impact strategy that significantly strengthens the institution’s capacity to drive change. It should be considered a best practice example because the governance model and its agile tools are fully replicable and adaptable by any other hospital pharmacy, establishing the pharmacist as a protagonist in healthcare innovation.
CONTINUITY OF PHARMACEUTICAL CARE BETWEEN HOSPITAL AND COMMUNITY: AN INTEGRATED ANALYSIS
European Statement
Introductory Statements and Governance
Author(s)
Chiara Cardinali, Massimo Fioretti, Carlo Polidori
Why was it done?
In some realities, recent laws allow the administration of hospital medications in outpatients setting by defining two dedicated paths: protected discharge and taking charge directly on the territory. This therapeutic approach is made possible by the collaboration between the clinicians and the community doctors.
The project aims to examine the continuity of pharmaceutical care in our reality taking into account some clinical outcomes, management implications as well as economic aspects.
What was done?
The Pharmacy Unit analysed all documentation, including prescriptions, from 2022 to the beninning of 2025, aiming to assess safety and adherence outcomes.
How was it done?
A written survey was conducted among community doctors and clinicians in order to evaluate their level of knowledge of the law and to collect their feedback.
Analysis of the 2023 final balance sheet enabled us to make some economic considerations.
Finally, we interviewed home nurses to find out their perception of risk related to the administration of hospital medications in outpatients setting.
What has been achieved?
There were 45 total runs, and the Infectious Diseases Unit was the most active department; consistently,77% of prescriptions included antimicrobials. None of the 140 pharmacovigilance reports was related to this pharmaceutical approach.
51 doctors completed the survey: among them, only 24 doctors were familiar with this law. Both community doctors and clinicians claim that the difficulty in collaborating with each other undermines the feasibility of the approach and they require greater support from hospital pharmacists.
A total of 678 days of hospitalisation were avoided: the financial savings amounted to EUR 1,130,904 over the three-year period.
Safety and collaboration were the themes that emerged from the 11 interviews that have been collected: nurses mentioned the risk of storing medicines at home, the transcription of therapies on several documents and the lack of protocols for managing emergencies at home.
What next?
In conclusion, this law represents an important opportunity for the quality and sustainability of pharmaceutical care, but it requires a collaboration between hospital doctors, community doctors and nurses that should be implemented with a solid and tailored organisational model.
THE STRATEGIC NETWORK OF THE PAEDIATRIC PHARMACIST GROUP IN THE CAPITAL REGION OF DENMARK AND REGION ZEALAND
Pdf
European Statement
Introductory Statements and Governance
Author(s)
JLV, Johanne Lundgaard Vedersø; CEGP Constance Eline Grandjean Poulsen; SLO, Sigrid Linnemann Otnes
Why was it done?
Pediatric medication poses challenges due to frequent off-label drug use in this population. Managing pediatric medications requires close interdisciplinary collaboration. The aim of a strategic network was to improve knowledge sharing and collaboration across hospitals and organizations, finding common solutions to challenges related to pediatric medication.
What was done?
The Pediatric Pharmacist Group (PPG) in the Capital Region of Denmark and Region Zealand established a strategic network.
How was it done?
Many hospitals, only have one pharmacist assigned to the pediatric department. This creates challenges for managing complex issues, with hospitals potentially opting for different solutions to a common issue. Cross-hospital knowledge sharing is therefore crucial. PPG has members across hospitals as well as in the pharmacy’s Department of Implementation and Information. This allows easy access to clinical teams, pharmacologists, and the hospital pharmacy, including the production department.
PPG was organized with a clear mandate, structured communication channels, meeting frameworks, and a knowledge-sharing system. This structure combined with the large interface of PPG, resulted in a strategic network which can quickly mobilize relevant experts to discuss pediatric medication challenges of common interest.
An example is a seminar on 3D-printed medicine, hosted by PPG and the pediatric team from the Department of Clinical Pharmacology. The hospital pharmacy’s production department is working on developing 3D-printed medicine. The seminar was used to share knowledge and discuss the clinical need for such medications in pediatrics. Stakeholders included representatives from the pharmacy, hospitals, two Danish regions, and various professional disciplines (pharmacists, clinical pharmacologists, nurses, and pharmacy technicians).
What has been achieved?
A strategic network has been established, enabling the rapid mobilization of experts to find common solutions to complex challenges across hospitals and organizations.
During the 3D-printed medicine seminar, knowledge was successfully shared across organizations, providing insights into clinical needs and production possibilities. These discussions will guide future work on 3D-printed medicine.
What next?
The “strategic network” concept can be applied to other clinical areas e.g., intensive care units and the area of antibiotics.
The long-term goal for PPG’s strategic network is to evolve into a national network, enhancing knowledge sharing and finding solutions to pediatric medication challenges across Denmark.
INTERVENTION OF THE HOSPITAL PHARMACIST TO VERIFY AND PROMOTE THE APPROPRIATENESS OF HUMAN ALBUMIN PRESCRIPTION IN AN ITALIAN HOSPITAL
Pdf
European Statement
Introductory Statements and Governance
Author(s)
Morati S 1 , Martignoni I 2, Grotto A 2, Filosofo M 3, Gambera M 2
1. University of Padova – School of Pharmacy
2. P. Pederzoli Hospital – Pharmacy Service
3. University of Milan – Specialization School in Hospital Pharmacy
Why was it done?
It is generally aknowledged that the albumin, as a medication, is overused. As it is also a limited resource, the role of the pharmacist is crucial to guarantee the appropriateness of the prescription and to prevent the use outside the indications approved by AIFA.
What was done?
The aim of the project was to promote the correct use of albumin administered to patients admitted to an Italian hospital and to verify the clinical effectiveness of its administration for therapeutic purposes. The aim should have been reached by the intervention of the hospital pharmacist who evaluated every single hospital department request form of albumin and, in case of doubt, called by phone clinicians.
How was it done?
The pharmacist’s intervention took place between 1 July 2022 and 1 July 2023. Once the albumina request form had been validated by the pharmacist, the vials were delivered and registered in the warehouse application and the excel sheet was updated with the patient’s blood values before and after albumin administration . The final step was to analyse the trends of patients’ blood albumin parameters.
What has been achieved?
373 albumin request forms with 20 different indications were received by the hospital pharmacy. In particular 78 for ‘major surgery’, 65 for ‘large volume paracentesis’, 43 for ‘protein dispersing enteropathies’, 79 for ‘other’.
Extrapolation of consumption showed that, following the pharmacist’s intervention, the use of albumin decreased to 3928 vials delivered compared to the same period in the previous year (1 July 2021 – 1 July 2022) when 14517 vials were delivered. From an economic perspective: the expense of albumina was as follows: €284,553.00 in 2021-22 and €76,998.00 in 2022-23.
The evaluation of the trend of the blood values after albumina administration showed that, if the treatment was appropriate, patients achieved positive results with a return to albumin values of 2.5 g/dl.
What next?
Our results show that a dialogue between hospital pharmacists and physicians, and a high focus on the use of albumin, can lead to more appropriate and effective use of albumin and significant cost savings. We would try the same approach to the use of immunoglobulines, blood derivatives with the same concerns (iperutilization, limited resource, high cost) of albumin.