UNIVERSITY OF MICHIGAN – DEPARTMENT OF PHARMACY SERVICES

 

ANNUAL REPORT FY2006

 

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Welcome From the Department of Pharmacy Services   |   Inpatient Drug Distribution Services   |   Clinical Pharmacy Services
Ambulatory Pharmacy Services   |   Medication Safety   |   Drug Information and Investigation Services
Research and Education   |   HomeMed Services   |   Computerization and Automation
Continuous Quality Improvement   |   Purchasing, Inventory, Management, and Distribution   |   Business Operations

DRUG INFORMATION AND INVESTIGATION DRUG SERVICES

 

Drug Information Service

 

The Drug Information Service provides pharmaceutical, pharmacological, and therapeutic information to the University of Michigan Hospitals and Health System and to health practitioners in the local area.  In FY06, the Service handled approximately 2500 questions for health care providers. In addition to providing drug information for patient care, the Service manages all drug shortages that require conversion to an alternative therapy or allocation of existing stock. Other responsibilities of the Drug Information Service include handling of product defects, drug recalls, review and approval of requests for preprinted orders, and participation in the development of clinical guidelines as requested. In FY06 the Service was active with the development of order forms to improve patient safety and prescribing of several agents (enoxaparin, IVIG, heparin).

 

Text Box: Gundy Sweet, Pharm.D. Coordinator, Drug Information and Investigational Drug Services The staff of the Drug Information Service support the functions of the UMHHC Pharmacy and Therapeutics (P&T) Committee and several of its subcommittees. In this capacity, they are responsible for conducting a thorough review of all published information related to safety and efficacy of new drugs, and to recommend the addition or deletion of products from the formulary, to recommend and implement therapeutic conversion programs, and to approve policies related to drug use. The P&T Committee is supported through several subcommittees including the Ambulatory Formulary Committee, Antimicrobial Subcommittee, Cancer Pharmacy Committee, Drug Use Evaluation Committee, Medication Safety Committee, and the Product and Vendor Selection Committee. Some of the key accomplishments of the Committee in FY06, either directly or through the subcommittees, include:

 

  • Reviewed 20 new pharmaceutical agents and over 120 medication line item extensions
  • Implemented and/or modified restriction criteria for several agents due to safety concerns, including new criteria for factor VII use in adult and pediatric patients
  • Updated membership on the P&T Committee to increase nursing representation, including representatives from Mott and UH inpatient units
  • Proposed and approved the Glycemic Management Subcommittee as an official subcommittee of P&T
  • Approved nursing driven policies including the vaccination program and the nicotine replacement protocol
  • Approved the Medication Administration Policy, a document that identifies who is authorized to administer medications
  • Approved guidelines for appropriate use of antifungal agents
  • Developed and/or revised several order forms to enhance patient safety and improve prescribing for restricted agents
  • Worked with the Orders Management Project for clinical and policy-related decisions in the development of CPOE
  • Implemented therapeutic interchange programs for generic Vicodin, tiotropium/ipratropium, and albuterol/levalbuterol.
  • Developed and posted preprinted order sets for several chemotherapy and investigational drug protocols to improve medication safety
  • Revised antiemetic guidelines based on new NCCN recommendations

 

The Ambulatory Formulary Committee is a multidisciplinary group with representation from several physician leaders, pharmacy services, M-CARE (the University’s managed care branch), and the pharmacy benefits program. The goal of this committee is to determine an educational drug list for preferred agents that provide good clinical care at reasonable costs. Academic detailing of pharmacy specific information is used to help direct ambulatory prescribing to the preferred agents. Accomplishments of this group in FY06 include:

  • Approval of funding to increase support (1 FTE of pharmacist) for Academic Detailing and predicted switch programs over the next 12-24 months
  • Approved a proposal for eight specialty drug categories in rheumatology and neurology to only be available through a limited pharmacy network, providing savings to patients, payers and the institution
  • Switched the University’s PBM to Catalyst RX
  • Distributed 15 targeted email communications (FGP-Grams) to medical staff about timely drug-related topics

Text Box: Drug Information • Handled 2,500 calls in the past year • Reviewed 20 new pharmaceutical agents and over 120 medication line item extensions Investigation Drug Service • Handled over 275 active drug protocols • Renovated the dispensing area to incorporate carousel technology

 

Health care staff are kept informed of Pharmacy and Therapeutics Committee decisions and new information regarding medications by means of the monthly, web-based Pharmacy ForUM Newsletter.

 

 

Investigational Drug Service

 

The Investigational Drug Service (IDS) is a medical-school-mandated service for research protocols involving human subjects that involve the use of medications not yet approved by the FDA. In addition, the Service handles multiple other protocols involving commercially available drug.  The goal of the IDS is to ensure that investigational drug studies and other drug-related research at the UMHHC are conducted in compliance with the requirements of the FDA, study sponsors, Michigan State Board of Pharmacy Regulations, and JCAHO. The IDS handled over 275 active drug protocols in FY06, with approximately 45% being done in oncology, and the balance in non-oncology studies. IDS staff work with investigators to improve study design and ensure feasibility of the study, establish randomization procedures, and monitor progress of the study through completion.

 

Major accomplishments for FY06 include further implementation of the new IDS computer system, WebIDS, for billing of satellite dispensings. A workload and budget analysis revealed a significant increase in activity in studies conducted in the Cancer Center. Additional FTEs (1 FTE technician and 0.6 FTE pharmacist) were approved to support this growth. The physical space of the IDS is currently being renovated to better accommodate its growth and to improve efficiencies.

 

Committees

 

Committee

Responsibilities

Ambulatory Formulary Committee

 

Charged with developing an ambulatory formulary and impacting physician prescribing in the ambulatory environment to reduce ambulatory pharmaceutical expenditures while maintaining optimal clinical care

Antimicrobial Subcommittee

Advises P&T Committee on issues related to antimicrobials

Cancer Pharmacy Committee

Advises P&T on issues related to cancer therapy

Drug Use Evaluation Committee

Reviews drug use within the institution in order to ensure compliance with criteria, and improve medication safety and fiscal accountability

Glycemic Management Subcommittee

Advise the P&T Committee on issues related to glycemic control for inpatients, including standardization of product selection, standardization of protocols, and transition of patients across environments.

MedSafe Committee

Reviews the medication use process to improve medication safety

Pharmacy and Therapeutics Committee

Charged with ensuring safe and effective drug use within the institution. Its activities are supported by several subcommittees

Product and Vendor Selection Committee

Reviews market changes in formulary products (new formulations, generics or pricing) to continually enhance formulary effectiveness