Treu CN, Vizzi C, Kum V
… +2 more, Brown J, Farmer B
Am J Health Syst Pharm
· 2026 May · PMID 41719055
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PURPOSE: The rise of multihospital health systems has complicated formulary and therapeutics (F&T) governance. Subcommittees can assist by addressing complex aspects of formulary management within a specific patient popu...PURPOSE: The rise of multihospital health systems has complicated formulary and therapeutics (F&T) governance. Subcommittees can assist by addressing complex aspects of formulary management within a specific patient population and overseeing clinical or operational challenges. This article describes the rationale, implementation, and impact of a Subcommittee of Emergency Medicine Therapeutics (SEMT), which was developed to address the unique medication management challenges in emergency departments (EDs) across a large healthcare system. SUMMARY: Established in 2021, the SEMT is a multidisciplinary subcommittee within the enterprise F&T committee that tackles the complexities of medication use in the ED environment. With a focus on optimizing medication safety, improving access, and formulating clinical guidelines, the SEMT has implemented several key initiatives. These include the creation of standardized medication kits, the introduction of medication safety protocols, and formulary enhancements that led to significant cost savings. Additionally, the SEMT has facilitated the development of clinical decision support tools and electronic health record enhancements to ensure consistent, safe, and effective medication use across the health system's EDs. CONCLUSION: The formation of the SEMT underscores the value of specialized subcommittees within large healthcare systems to address the unique needs of specific clinical environments. The committee's work has improved patient safety and care efficiency, as well as delivered cost savings, making it a valuable model for other large health systems seeking to enhance their emergency medicine therapeutics. As healthcare organizations continue to grow, integrating such focused subcommittees can lead to improved outcomes and a more standardized approach to evidence-based care.
Stepanovic M, Eckel SF, Morbitzer KA
… +1 more, Vest TA
Am J Health Syst Pharm
· 2026 Feb · PMID 41703768
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PURPOSE: To define the key domains and knowledge areas necessary for effective pharmacy supply chain (PSC) practice and to establish a validated framework that can guide curriculum development. As pharmacists increasingl...PURPOSE: To define the key domains and knowledge areas necessary for effective pharmacy supply chain (PSC) practice and to establish a validated framework that can guide curriculum development. As pharmacists increasingly take on strategic roles in procurement, logistics, and medication-use systems, structured education is needed to prepare them for the evolving demands of PSC leadership. METHODS: This national, consensus-based study was conducted from spring 2024 to spring 2025 using a 3-phase design. Twenty-two pharmacy leaders participated in structured focus groups (phase 1, n = 10) and an independent curriculum review (phase 2, n = 12), followed by a modified Delphi consensus survey (phase 3). Participants identified and refined PSC knowledge areas and domains and rated each for frequency of use and perceived importance. Curricula from 12 supply chain programs based in the United States were reviewed to benchmark topic coverage. RESULTS: A 5-domain framework was developed: (1) Manufacturer (Supply and Procurement), (2) Distribution (Logistics, Inventory, and Warehousing), (3) Operations (Procurement, Management, and Automation), (4) Medication Use Management (Practice, Value, and Patient Care), and (5) Overarching Competencies. All domains met the a priori consensus threshold of ≥80%. Participants rated traditional supply chain topics-such as sourcing, cost analysis, and supplier strategy-as critically important but infrequently used. Many selected pharmacy-centric topics even when exposed to broader supply chain curricula. CONCLUSION: This study introduces the first validated PSC framework to inform pharmacy education. It provides a foundation for developing pharmacy-specific curricula that reflect current practice gaps and enable pharmacists to lead within increasingly complex supply chain environment.
Am J Health Syst Pharm
· 2026 Feb · PMID 41703760
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PURPOSE: Radio frequency identification (RFID) technology has been proposed to be the barcode of the future, with new technology forms such as Bluetooth low energy (BLE) integrated into real-time location systems (RTLS)....PURPOSE: Radio frequency identification (RFID) technology has been proposed to be the barcode of the future, with new technology forms such as Bluetooth low energy (BLE) integrated into real-time location systems (RTLS). In health systems, RTLS have evolved to track medical equipment and other assets via BLE beacons that transmit data via serial numbers to a gateway, which relays information to a software system to display current location. This case study explored how BLE beacon data and RTLS can be leveraged to enhance interdisciplinary workflows and streamline crash cart management. SUMMARY: Houston Methodist implemented a BLE-based tracking system for 349 crash carts across 8 hospitals. Pharmacy and central supply teams collaborated to develop a standardized workflow for maintaining crash carts. Integration with an existing inventory management system enabled real-time visibility of cart locations and expiration tracking of medications and supplies. The new workflow for crash cart management streamlined operations, decreased staff workload, and increased patient safety. Implementation challenges included vendor transitions, gateway visibility, and staff training, which were addressed through interdisciplinary coordination and technological enhancements. The visibility of crash carts improved from 0% to over 90% at most sites, and labor savings at the flagship hospital were estimated at $8,500 annually. CONCLUSION: BLE-enabled RTLS significantly improved crash cart visibility, streamlined labor hours, and enhanced operational efficiency. This case study supports national recommendations for integrating RFID technologies into medication-use systems and highlights the importance of interoperability, stakeholder engagement, and workflow standardization. The findings may inform broader adoption of RTLS in health systems seeking to enhance safety and streamline operations.
Am J Health Syst Pharm
· 2026 Feb · PMID 41693160
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PURPOSE: Transitions in leadership within pharmacy residency programs can impact the continuity, quality, and regulatory compliance of a program. There is a gap in the literature regarding best practices for transitionin...PURPOSE: Transitions in leadership within pharmacy residency programs can impact the continuity, quality, and regulatory compliance of a program. There is a gap in the literature regarding best practices for transitioning between outgoing and incoming residency program directors (RPDs). The objective of this project was to describe and evaluate the process used to longitudinally transition the RPD role of an American Society of Health-System Pharmacists (ASHP)-accredited residency program. SUMMARY: The transition process was described using a systematic approach to retrospectively reconstruct core transition elements through a review of relevant documents and materials from the 12-month transition process. Materials were reviewed and items categorized via consensus of the study team. The effectiveness of the developed RPD transition process was evaluated by examining program-specific metrics before, during, and following the transition. Based on this review, a transition timeline identifying key transition checkpoints and a transition-specific task list were created. Quality indicators during the transition were generally positive: The number of applicants was maintained, the percentage of on-time summative evaluations increased, the percentage of on-time quarterly development plans increased, and the percentage of on-time initial development plans decreased. CONCLUSION: A structured plan for the transition from outgoing to incoming RPD appeared to allow for quality maintenance and smooth transition of a pharmacy residency program. Identified factors that facilitated a smooth transition included leveraging RPD-specific skill sets and the openness of incoming and outgoing RPDs to suggested program adjustments or improvements.
Lee PK, Isajloska-Jasmak G, Aly S
… +2 more, Tariq F, Shah PJ
Am J Health Syst Pharm
· 2026 Feb · PMID 41689280
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PURPOSE: Antiretroviral stewardship programs have been recommended by several organizations, including the Infectious Diseases Society of America, to minimize medication errors that may adversely affect people living wit...PURPOSE: Antiretroviral stewardship programs have been recommended by several organizations, including the Infectious Diseases Society of America, to minimize medication errors that may adversely affect people living with human immunodeficiency virus (HIV). To date, the role of antiretroviral stewardship has largely been studied in tertiary or quaternary care medical centers with dedicated infectious diseases pharmacists, complex patient populations, and robust clinical laboratory services. Thus, limited data are available in lower-acuity community hospital settings. The purpose of this study was to evaluate the impact of pharmacist-led antiretroviral stewardship on antiretroviral therapy (ART)-related medication error rates in community hospital settings. METHODS: This was a multicenter retrospective chart review of patients receiving ART during admission to 6 community hospitals of a large health system between May and July 2024. ART-related medication errors were defined as incomplete ART regimens, inappropriate or absent opportunistic infection (OI) prophylaxis, incorrect dose adjustments due to renal function, or unaddressed drug-drug interactions (DDIs). Patients were excluded if they were receiving ART for pregnancy, neonates, hepatitis B, pre-exposure prophylaxis, or post-exposure prophylaxis, had a length of stay under 48 hours, or died within 48 hours of admission. RESULTS: Of 247 patients who received ART during the study period, 94 were excluded based on the predefined criteria, with 153 patients included in the final analysis. The mean age was 52 years, and 68% (n = 104) of patients were male. CD4+ T cell counts below 200 cells/mm³ were observed in 37% (n = 57) of patients, and 77% (n = 118) were on a single-pill regimen. Pharmacist interventions occurred in 67 patients (44%), with OI prophylaxis (n = 10) being the most frequent intervention. The rate of ART-related medication errors was significantly lower in the pharmacist intervention group (7.5%, n = 5) than in the nonintervention group (23%, n = 20; P = 0.009). In the pharmacist intervention group, unaddressed DDIs (n = 3) were the most common error, whereas in the nonintervention group errors most frequently included inappropriate or absent OI prophylaxis (n = 9), incomplete ART optimization (n = 6), unaddressed DDIs (n = 5), and incorrect renal dose adjustment (n = 2). CONCLUSION: In community hospital settings, ART-related medication error rates were significantly lower among patients who received pharmacist-led intervention, supporting the role of antiretroviral stewardship in improving medication safety in hospitalized persons with HIV.
Caniff KE, Rebold N, Richards N
… +11 more, Torney N, Rodriguez E, Angel A, Motley J, Steffke N, Holger DJ, Veve MP, Scipione MR, Haddad A, Brennan B, Rybak MJ
Am J Health Syst Pharm
· 2026 Feb · PMID 41689279
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PURPOSE: Discharge antibiotic prescriptions are infrequently monitored by hospital antimicrobial stewardship programs but are often guideline-discordant. Leveraging pharmacist expertise may optimize discharge antibiotic...PURPOSE: Discharge antibiotic prescriptions are infrequently monitored by hospital antimicrobial stewardship programs but are often guideline-discordant. Leveraging pharmacist expertise may optimize discharge antibiotic prescribing, benefiting the individual patient and public health. METHODS: This is a multicenter, quasi-experimental study of an intervention in which a pharmacist reviewed, documented and communicated standardized discharge antibiotic recommendations to the primary inpatient medical team. Patients were compared prior to intervention implementation (the preintervention group) to those after intervention implementation (the postintervention group). The primary outcome was overall discharge antibiotic appropriateness, defined as the prescription having an appropriate duration, agent, and dose. Clinical outcomes, including adverse drug events, 30-day hospital or emergency department readmission, and 30-day infection recurrence were compared. The pharmacist interventions in the postintervention group were classified and evaluated for provider acceptance. RESULTS: A total of 157 patients from 4 community hospitals across 3 health systems were included (87 in the preintervention group and 70 in the postintervention group). Common infection sources were the urinary tract (53.5%) and lower respiratory tract (36.3%). In the postintervention group, pharmacists made 57 interventions, most commonly proactive discharge regimen recommendations (43.9%), therapy discontinuation (26.3%), and duration adjustments (17.5%). Overall, 63.1% of interventions were accepted. Compared to the preintervention group, postintervention patients had a significantly higher frequency of discharge with an appropriate antibiotic regimen (50.0% vs 21.8%, P < 0.001). No significant between-group differences were observed in any 30-day clinical outcomes. CONCLUSION: A pharmacist-driven discharge antibiotic intervention significantly improved the appropriateness of antibiotic prescribing in community hospitals. These findings support the role of pharmacists in enhancing antimicrobial stewardship at important care transitions.
Am J Health Syst Pharm
· 2026 Feb · PMID 41686696
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PURPOSE: Ensuring accuracy in pharmacy medication inventories is fundamental to effective pharmacy practice. The complexity of managing these inventories increases when multiple systems are utilized. This study investiga...PURPOSE: Ensuring accuracy in pharmacy medication inventories is fundamental to effective pharmacy practice. The complexity of managing these inventories increases when multiple systems are utilized. This study investigates the challenges and solutions associated with the integration of central pharmacy automation (CPA) and automated dispensing cabinets (ADCs) with an inventory management system. Our primary objective was to achieve precise inventory counts across all platforms, thereby enhancing operational efficiency and patient safety. SUMMARY: To achieve accurate inventory counts, a comprehensive mapping of system interactions and refinement of interface messages was conducted. Key interventions included interface mapping, translating actions into inventory updates, establishing a systems architecture hierarchy, and optimizing data flow logic. By synchronizing individual physical drug movements with real-time digital records in the inventory management system, significant reductions in inventory discrepancies were realized, leading to enhanced overall system reliability. CONCLUSION: Our findings provide valuable insights for pharmacy departments managing complex inventory systems involving multiple automation systems. It highlights the importance of meticulous interface design and adherence to standardized workflows. By sharing our experience and best practices, other institutions facing similar challenges can adopt these strategies to improve inventory accuracy. Ultimately, enhancing inventory management contributes to better patient care and more efficient operations.
Am J Health Syst Pharm
· 2026 Feb · PMID 41686691
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PURPOSE: National publication rates of pharmacy resident research are low, but an analysis of research design has not been conducted. The PICO (population, intervention, comparison, outcome) framework is an evidence-base...PURPOSE: National publication rates of pharmacy resident research are low, but an analysis of research design has not been conducted. The PICO (population, intervention, comparison, outcome) framework is an evidence-based method for developing sound research questions. The primary objective of this study was to determine the percentage of pharmacy resident research abstracts that included all 4 components of PICO. METHODS: This was a retrospective cohort analysis of resident research project abstracts accepted to the Great Lakes Pharmacy Residency Conference (GLPRC) between 2017 and 2019. Abstracts and resident demographic information from this time period were requested. Each abstract was analyzed for utilization of PICO components. After PICO analysis, the abstracts were stratified based on program year. Each subgroup was categorized based on the number of PICO components included and the frequency of omission for each component. Embase and PubMed were queried for subsequent publication. RESULTS: A total of 1,822 abstracts were included in the analysis. All 4 PICO components were included in 59.4% of abstracts. Of the postgraduate year 1 abstracts analyzed (n = 1,388), 60.1% included all 4 PICO components, compared to 56.6% of postgraduate year 2 abstracts (n = 434). The least common component of PICO included in abstracts was a comparator (only 63.9% of abstracts included a comparator group). Overall, 6.7% of the abstracts were published as manuscripts. PICO characteristics were not significantly different between abstracts that were and were not published. CONCLUSION: These results demonstrate that approximately 60% of research projects presented at GLPRC between 2017 and 2019 included all 4 evidence-based components that contribute to a quality study design. The use of PICO was not significantly different between training years (postgraduate year 1 vs year 2). PICO characteristics were not associated with the publication status of the abstract.
Am J Health Syst Pharm
· 2026 Feb · PMID 41685821
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PURPOSE: As clinical trials become increasingly complex, investigational drug services (IDS) pharmacies face growing demands in study management. The purpose of this prospective time study was to evaluate the utility of...PURPOSE: As clinical trials become increasingly complex, investigational drug services (IDS) pharmacies face growing demands in study management. The purpose of this prospective time study was to evaluate the utility of the Vizient IDS Complexity Scoring Tool (CST) in predicting the effort required by IDS pharmacists for study activation based on the assigned CST score. By quantifying the time spent on activation activities, this study aimed to determine whether actual effort aligns with the CST-assigned score. SUMMARY: Time data were collected for the following types of study activation activities: (1) preparation of site-specific pharmacy documents and (2) computerized provider order entry setup and integration into the electronic health record. Nine pharmacists contributed to data collection between September 2024 and February 2025 for 45 new studies with activation activities during this period. For both non-hematology/oncology and hematology/oncology studies, the effort required (time spent) generally increased as study complexity increased. The task-based effort was not comparable for non-hematology/oncology studies and hematology/oncology studies of the same complexity level, with specific activities identified that distinguished the effort needed for a non-hematology/oncology vs hematology/oncology study. CONCLUSION: While the CST can estimate effort based on study complexity, it does not differentiate complexity by therapeutic area. Using real-world data based on IDS practice experience, this study confirmed that hematology/oncology studies require greater effort for certain study activation activities than non-hematology/oncology studies. There is an opportunity to continue refining the CST as a valuable tool for assessing study complexity.