The Winnipeg Regional Health Authority (WRHA) has created a collaborative, multi-facility pharmacy approach to manage medication supply chain issues such as backorders, shortfalls, and critical drug shortages. Despite having different infrastructures at various facilities in the WRHA (e.g., finance and drug procurement systems), it was able to achieve the sharing of scarce drug inventory across the whole organization. It moved to a regional management process from what was sometimes a site-based, 'stock piling/hoarding' response to drug shortages. This was done without new resources. Also, through this initiative, new tools and processes were created that led to better sharing of information about supply chain issues among pharmacy staff, prescribers, and clinical program leaders within the WRHA, as well as among pharmacy leaders at other regional health authorities in Manitoba. In addition, stakeholders are informed about supply chain issues before they reach the level of crisis/critical shortage (the point at which patients/clients are directly affected). The process has helped to improve patient safety, medication access, and worklife. To implement this process elsewhere requires a desire to work collaboratively across multiple health care facility pharmacies, effective communication links, a willingness to redefine pharmacy personnel job duties, and a finance system that permits inter-facility charging for inventory that is shipped between facilities (e.g., to create a single site depot for sequestered stock, or to remedy a shortfall).

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