Spotlight: Pharmacy Services

Improving Accessibility, Enhancing Safety, and Reducing Costs

The strong partnership between Premier Health Pharmacy Services and physicians provides many benefits for patients, including the safety and affordability of medication and the ease of transition from hospital to home.

The expertise of the pharmacy staff is critical for physicians such as Steven Burdette, MD, medical director of infection prevention and antimicrobial stewardship for Miami Valley Hospital. “They are the conduit between the critical care team and myself,” he says.

Many departments at Miami Valley Hospital, such as medical, neurological and surgical critical care, and oncology, have their own dedicated pharmacist. “They are the experts in terms of medications, and they are trained to a greater degree than physicians to look for side effects,” Dr. Burdette says. “With complex patients, there’s not one dose that works for every patient. A lot of adjustments have to be made.”

At Miami Valley Hospital, Pharmacy Services “has strategically placed satellites in high-volume areas,” Dr. Burdette says. “I can walk to a pharmacy satellite and talk to a pharmacist in the intensive care unit, and have a face-to-face conversation, which is very positive for patient care.”

On-site pharmacists also can determine cost and coverage of medications before the patient leaves the hospital. “We can tell patients, ‘Your antiobiotic will cost you this amount – is that a reasonable price, or should we look for something cheaper?’” Dr. Burdette says.

Pharmacy Services and anesthesia providers have been working together closely this year on cost-savings initiatives. “They have been able to significantly decrease the use of some medications, such as Ofirmev and vasopressin,” says Becky Sillaman, system director for Pharmacy Clinical Services. “Partnerships such as these will be key as we move forward to help drive health care costs down.”

Vince Yahl, pharmacy site manager for Upper Valley Medical Center, says that Premier Health’s pharmacy services are invaluable for small rural communities, enabling patients to seek treatment and fill prescriptions close to home. “The medical center offers a wide range of services,” Yahl says. “Pharmacy is doing more all the time to support our comprehensive services.”

Another chief advantage of on-site pharmacies is the ease of transition for patients. “They can get their prescriptions filled in our outpatient pharmacy before they go home,” Yahl says. “The patients receive a list of their medications with instructions when they get discharged. Those who get their new prescriptions filled here have the medications they need immediately.”

In addition, UVMC pharmacies have adopted measures to enhance safety, including scanning the barcode of each ingredient of every IV prepared and the use of Epic’s Secure Chat (Haiku) to communicate with physicians. “These messages are received by the provider in Epic or on their smartphone. It gives the physicians some information about what we need clarified, and they can call us back when they are available,” Yahl says. 

Premier Health also promotes partnerships that enhance patient care, notably the System Pharmacy and Therapeutics Committee, comprised of medical staff representatives of various specialties and practice sites. The goal is to promote the safe use of medications while fostering cost containment. “There are not that many opportunities to get so many specialists together, and we all take the role very seriously,” says Dr. Burdette, a committee member. “We are monitoring data to determine if we are providing the best care possible. It plays a significant role in patient safety.”

Medication safety often happens behind the scenes, Sillaman says: “Pharmacy reviews more than 100 medication-related adverse events each month, some of which result in system improvements to prevent recurrence. This comes in the form of policy updates and changes, order set reviews and revisions, EPIC entry modifications, and staff education. Premier Health has a drug diversion officer who works collaboratively with the pharmacy operations team, nursing, and providers to establish best practices for all aspects of the control of controlled substances.”

Patient safety also is enhanced by formulary management. “While financial considerations play a role in the decision process, formulary management is much more than medication cost,” Sillaman says. “The formulary drives superior evidence-based patient care, helps achieve therapeutic goals, and improves patient safety – all while curtailing expenses.”

Back to the July 2019 issue of Premier Pulse