Clear communication is essential to providing optimal patient care and enabling this requires the involvement of many different health-care services, all of which need access to a wide range of medication information. Institution specific information on drug formulary and policies, drug shortages, medication safety, and Joint Commission (TJC) initiatives need to be readily accessible to health care providers in order for them to make appropriate, point of care decisions.
As with most health systems, West Penn Allegheny Health System (WPAHS) was faced with the challenge of enabling effective communication that would allow the implementation of drug policy initiatives across multiple practice sites. In an effort to overcome this challenge, we proposed an online drug information and formulary management repository as a tool to bridge the communication gap between pharmacy and health care practitioners. In order to bring this to fruition, we created multi-disciplinary processes through which our health system could implement such a system and thereby provide each practice area with the information they need.
Identifying the Problem and the Solution
WPAHS currently comprises five hospitals and four outpatient care centers. In the past, access to health system drug formulary and clinical drug information was fragmented and it was difficult to consolidate into a single resource. Such information was housed in several different places within our various institutions including the health system’s intranet, on individual departmental shared drives, on employees’ personal drives, and in the individual minds of our health-care professionals. To create a single source out of these disparate storage areas, pharmacy administrators envisioned a multi-disciplinary, one-stop-shop for drug formulary and clinical information, and proposed the development of a universal Website to WPAHS administration as a solution to this problem. Recognizing the merit and value of such an information clearinghouse, the pharmacy department was authorized to purchase formulary management software that would allow us to create a drug database to mirror the health system’s drug formulary. In addition, the software now provides our health care providers a place to communicate critical drug information to all affected employees of the heath-system.
Once the software was purchased, a multi-disciplinary team of pharmacists, pharmacy technicians, student interns, physicians, and nurses was formed to determine appropriate content for the Website. After discussing the various needs and desires of these groups, we chose to include the heath-system’s drug formulary (with drug-specific links to REMS and black-box warnings), approved therapeutic interchanges, drug policies, current drug shortages, medication safety information, links to the FDA, ISMP, ASHP and other agencies, as well as additional clinical information pertaining to the drug formulary. Each type of health care professional (eg, nurses, pharmacists, physicians) has a link to a page specifically designed to address their needs. For example, the pharmacy department’s orientation and training manual, annual competency testing program, and a list of current drug shortages are posted to their page on the site, thereby encouraging pharmacy staff to incorporate review of the site into daily work activities. In addition, comments and suggested updates can be submitted to the development team via a link on the site.
The Website was initially introduced for staff use at our largest hospital—Allegheny General—through a social event to test its effectiveness. There, staff were shown how to navigate the site and were able to familiarize themselves with the contents through a Powerpoint presentation, interactive training, and a quiz. In order to present the contents to as many affected parties as possible, the site also was demonstrated to clinicians at staff meetings.
The formulary management Website registered over 4,500 hits in the first month of operation at Allegheny General. The results of a staff survey a few weeks after go-live indicated staff sentiment that the online repository is beneficial and supports their daily clinical efforts. Prior to this system, staff members expressed difficulty and frustration in locating up-to-date drug information as doing so was laborious and overly time consuming. The post-go-live survey results indicated that our staff feels this site improves patient care by enabling fast and efficient location of drug related information. Thus far, suggestions for improving the site have been minor including redesigning some of the pages to enable easier navigation and improving search functionality. Overall, our staff at Allegheny General feels the online formulary management site has greatly improved communication and provided peace of mind that all information is located in one place.
Improved communication, transparent formulary management, and the ability to universally convey implemented drug policy initiatives within our health system were our primary goals with this project, and we feel we have accomplished these goals at the initial site. Based on the success of this project, our health system plans to expand its scope to all practice areas within the health system. The site is also expected to be a powerful tool in implementing a system-wide drug formulary.
Terri Albarano, PharmD, MS, is interim manager of operations for Allegheny General Hospital in Pittsburgh, Pennsylvania. She received both her PharmD and MS in pharmacy administration from the University of Pittsburgh.
David Cecere, PharmD, MBA, is the system director for the pharmaceutical supply chain at West Penn Allegheny Health System. He received his PharmD from the University of Arkansas and his MBA from the University of Pittsburgh.
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