Oklahoma City VA Pharmacist Saves VA $3.5 Million, Recognized with National HeRO Award

“Cost-efficiency is a large component of my role within the OKC VA Pharmacy,” Dr. Kyle Filby said. “And asking the question, ‘is there a more efficient way?’ In this instance, comparing several products and packaging, I realized that this product was about 40% lower per unit.”

The medication in question was cyclosporine ophthalmic emulsion, or medicated eyedrops. A 30-dose bottle was prescribed for once-a-day treatments and two 30-dose bottles for twice a day treatment or a 90-day supply was prescribed.

Dr. Filby noticed a 60-dose bottle cost about 40% less than two 30-dose bottles.

“This led me to question- how we could improve the process,” Dr. Filby said. “I reached out within our region as well as National to request a review.”

This led to a change in the procedures and ultimately saving the VA approximately $3.5 million.

“Our pharmacy leadership strives to be open and encourages team members to make a difference and feel empowered to bring change,” Dr. Filby said. “Don’t be afraid to take the steps to ask the questions and seek out the answers.”

“Our pharmacists and technicians work hard to constantly improve the safety and effectiveness of the drug therapies that we provide to our Veterans,” said Chris Gentry, Chief of Pharmacy Services. “It’s always rewarding when our efforts are recognized and applauded. High Reliability Organization concepts have been repeatedly emphasized to our staff and has become an integral part of our culture.”

A High Reliability Organization (HRO) experiences fewer than anticipated accidents or events of harm despite operating in highly complex, high-risk environments, where even small errors can lead to tragic results.

The concept was pioneered in industries like aviation and nuclear power that were able to reduce accidents in their complex environments.

HROs avoid harm by becoming proficient in three pillars of High Reliability (Leadership Commitment, Culture of Safety and Continuous Process Improvement) while ensuring their staff members adhere to the VA foundation of high reliability principles and values.

“At the OKC VA HCS, we engage our leadership and employees to create and sustain a safety culture; one in which employees actively report safety concerns or other issues, without fear of reprisal or punitive action,” said Aaron Kabrick, HRO Lead. “We want our employees to know that this organization supports our employees to be honest, accountable and report inconsistencies, even if they are their own errors, so the organization as a whole can learn from failures, without fear of reprisal and ultimately improve upon our VA healthcare delivery system.”

It was this support from the VA that made Dr. Filby confident in reporting this discrepancy.

“At our VA and certainly within our department, we’re always encouraged to use the key HRO principles and investigate ways to improve systems,” Dr. Filby said. “With this culture, I felt comfortable in presenting my findings both to local supervisors as well as National.”

Phillip Ybarra, Public Affairs Specialist

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