Creation and execution of an effective critical care pharmacist collaborative in an academic health system

Abstract

Hospital systems continue to face significant pressure to mitigate medication costs, which may be achieved by effective pharmacy collaboration between medical centers. The purpose of this narrative is to discuss the essential elements, methods, obstacles, and solutions that were encountered in the formation and function of a successful multicenter pharmacy collaborative. The objective is to share the tools and examples that illustrate the framework and mechanics employed by a collaborative to execute initiatives that improved patient care and institutional processes. In 2018, five academic medical centers (AMCs) formed a critical care pharmacy collaborative team (PCT). The group's sustainable leadership structure allowed for equal voicing while avoiding individual burnout. Focused monthly working meetings allowed for comparison of each AMC's best practices to identify unexplored practice gaps and project planning. System goals with standardized metrics were set and parallel institutional approaches were implemented. Pooling use experience from five AMCs allowed for a larger sample size for data evaluation to assist in management of high impact medications. Additional benefits of group collaboration extended to research opportunities and incorporation of pharmacy learners for practice‐based learning. During this journey, barriers were uncovered including inconsistent access to a centralized secure platform for information sharing, data collection and analysis, overreliance of responsibilities on few individuals, and unpredictable dedicated project time for team leads and members. Overall, pharmacist led stewardship projects across five AMCs were leveraged to advance patient care through increased clinical guideline adherence, operational efficiency, and medication cost savings.