Business continuity plans for hospital pharmacies: a Delphi consensus

Business continuity plans (BCPs) are vital for hospital pharmacies (HPs) seeking to maintain essential operations during crises. Although generic BCPs exist, we found no guidelines for HP BCPs. We sought to use an expert consensus methodology to develop specific recommendations for BCP content for HPs.

An expert panel comprising hospital chief pharmacists, deputies or quality managers conducted a two-round Delphi study. Participants were recruited from civilian HPs in Switzerland and from two civilian and one military HP in each of Austria, Belgium, France, Germany and Italy. Recommendations were structured around the 'all-hazards' framework and practical examples were developed based on the literature and investigators' experiences in disaster simulation. A five-member multidisciplinary steering committee refined the recommendations before each round of voting. Experts rated recommendations on a scale from 1 to 9, and the RAND/UCLA method was used to determine consensus. In Round 2, recommendations without consensus in Round 1, newly proposed recommendations and recommendations with comments in Round 1 requiring rephrasing were submitted.

Of 71 experts contacted, 24 participated, with 18 responding in Round 1 (75% response rate) and 15 responding in Round 2 (83% response rate). Most experts came from Switzerland (78%) and civilian hospitals (94%). Half were chief pharmacists and only 17% had no BCP available in their HP. In Round 1, 41 recommendations were submitted, of which 100% were validated. Eleven recommendations were submitted in Round 2, including one new proposal and 10 rephrased recommendations from Round 1. Experts had to select their preferred version. The new recommendation was validated and all the rephrased recommendations were preferred. The final list comprised 42 recommendations for developing BCPs for HPs.

Our consensus-based BCP guidelines provide practical recommendations for civilian and military HPs and will help them develop BCPs for future crises and major business disruptions.