Managing medications amidst a pandemic
When COVID-19 cases started to surge in New York City earlier this year, Mount Sinai Health System had to pivot quickly to care for an increasing number of patients infected with the coronavirus. Susan M. Mashni, PharmD, BCPS, Vice President and Chief Pharmacy Officer at Mount Sinai Health System said the pandemic greatly affected its ability to order, distribute and manage medications across its eight hospitals and the overflow field tent intensive care unit (ICU) it managed in Central Park.
“On the inpatient side, every unit in the hospital became a COVID-19 unit – from our endoscopy suite to the post-anesthesia care unit – and we were seeing patients in the park, too,” she said. “That meant we had to buy a lot of medications for all these patients, as well as completely reorganize what medications we were storing at each place and how we could efficiently deliver medicine with about a 25% reduction in our nursing staff because many of them, too, were testing positive.”
Those new challenges meant that Mashni and her team relied on different technology solutions as they reconfigured their medication management strategy across the board. She credited “everything we’ve ever done to prepare for Joint [Commission] accreditation” as benefiting them as they worked to meet the moment and revamp their processes.
She said Mount Sinai put patient safety at the forefront of all they do – but when you are dealing with high-risk medications, and a lot of different stakeholders touching them in different places, it’s vital to have interoperability and transparency across the enterprise.
“When a patient comes into the emergency department, then goes to interventional radiology and then on to the ICU, there needs to be visibility into what medications were administered at every step – you need to see the patient’s full medication history in real time,” she said. “You also need the safeguards, reminders and double-checks to make sure you are giving the right patient the right drug at the right time, whether you are the pharmacist or the nurse doing the administration.”
Those same technologies also helped Mashni and her team keep up with enterprise inventory management as the demand for many drugs, especially anticoagulant, pain and paralytic medications, dramatically increased as care teams learned more about how to treat the novel coronavirus.
“We had a virtual inventory across our system – and then we set up a stockpile inventory so staff could purchase out of the stockpile in addition to purchasing from normal vendors,” she said. “We had to use vendors we had never used before to fill in the holes and did a lot more purchasing directly from pharmaceutical companies. Having the ability to see that virtual inventory so that buyers could see what was available right now was really critical in getting us over the hump, so we had what we needed for our patients.”
Now a few months out from that initial crush of COVID-19 cases, Mashni said there is no substitute for having a strong strategy in place to continue safe and efficient medication management practices no matter what crisis might come next.
“It is so important to have the tools that allow you to be flexible with your teams, to use your infrastructure to keep up with inventory and have the right stakeholders at the table to carefully think through what you need for overall management,” she said. “But that all starts with having those medication management basics down – and the right strategy in place – before any emergency hits.”
On Feb. 25, attend an interactive virtual event hosted by BD: Infection Prevention and Pharmacy: The Road to Integrated Stewardship During a Pandemic. Healthcare experts will discuss process improvement, drug optimization and drug resistance mitigation efforts, which are escalated during surge capacity situations. Join BD in leading the way to emerging stronger, together. Click here to learn more and register.