In April of 2021, the California State Board of Pharmacy presented several concerning findings in its Medication Error Reduction and Workforce Chair Report.1 The Report was conducted in response to several national news stories detailing pharmacy staffing shortages and medication errors. This report included a workforce survey administered to thousands of licensed pharmacists across the state.2 The survey revealed that 91% of retail pharmacists reported insufficient staffing to ensure safe patient care with another 83% reporting a lack of sufficient time to provide safe patient consultation. Another 78% of retail chain pharmacists also reported inadequate time to perform proper health screenings prior to the administration of immunizations.2 These survey findings underscore the reality of chronic understaffing across retail chain pharmacies and their impact on the safe and effective provision of healthcare services to patients. The report also details observations that these findings may increase the possibility of medication errors and compromise patient safety.
On October 8, 2023, Governor Gavin Newsom signed Assembly Bill 1286 (AB 1286), a first-in-the-nation legislation that introduces regulations to address pharmacy workforce understaffing and patient medication errors at corporate, retail chain pharmacies.3 The legislation, championed by Assemblymember Matt Haney of San Francisco and sponsored by the California State Board of Pharmacy, has several components and aims to tackle the absence of a centralized reporting mechanism for medication errors by mandating corporate chain pharmacies report all such errors to the California State Board of Pharmacy, establishing a function lacking in the existing system. AB 1286 also establishes baseline pharmacy staffing rules to ensure adequate support exists for California pharmacists in fulfilling prescriptions and administering vaccinations. The legislation grants licensed pharmacy staff more autonomy over staffing and working conditions, with the goal of enhancing patient care and safety across the state. It also introduces pathways for temporary pharmacy closures in rare and dangerous situations. In cases where a pharmacist deems the work environment dangerous to patients and store management fails to address the issue, temporary closure becomes a viable option.
Pharmacists serve critical roles in a variety of health care settings and these roles have developed over time to meet changing patient, health care system, and public health needs. Recognizing the consequences of medication errors, AB 1286 aims to shift decision-making authority from chain store management to pharmacists, acknowledging their extensive clinical education and expertise. This move ensures a safer and more responsible provision of medications and counseling, even in potentially dangerous, understaffed situations. Moreover, its enactment into law sets a precedent for the nation by reinforcing the state's commitment to prioritizing patient safety and pharmacy workforce sustainability.
Kyle M. Sousa, PhD
Dr. Sousa is a Professor of Pharmaceutical Sciences and currently serves as the Dean of the School of Pharmacy. His research interests include pharmacy workforce sustainability and professional advocacy efforts.
- California State Board of Pharmacy, Medication Error Reduction and Workforce Chair Report: https://www.pharmacy.ca.gov/meetings/agendas/2022/22_apr_bd_mat_ix.pdf
- California State Board of Pharmacy, Department of Consumer Affairs Workforce Survey: https://www.pharmacy.ca.gov/meetings/agendas/2021/workforce_presentation.pdf
- Assembly Bill 1286: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1286