Friday, April 16, 2010

MGH Pharmacy restructures and expands

PATIENT SAFETY LEADERS: Back row, from left, Mitrano, Arpino and Vetrano. Front row, Ryle, left, and Clapp MGH Pharmacy restructures and expands

APPROXIMATELY 6.4 million medication doses are dispensed to inpatients every year at the MGH. Behind this complex and important hospital function is the MGH Pharmacy, which has undergone a number of changes over the past year, all aimed at enhancing services offered throughout the hospital.

Margaret Clapp, MS, MDiv, RPh, who leads the department, has been promoted from director of pharmacy operations to chief pharmacy officer. To support her, five associate chief pharmacy officer positions have been created. Associate chiefs and their areas of focus are: Paul Arpino, PharmD, BCPS, clinical services; Ray Mitrano, MS, RPh, inpatient pharmacy operations; Karen Ryle, MS, RPh, community and outpatient pharmacy services; John Vetrano, PharmD, RPh, clinical trials; and Ron Imperiali, RPh, computer, automated systems and informatics projects.

In addition to a restructured leadership team, MGH Pharmacy has altered its general staffing model to increase the number of pharmacists dedicated to patient care units. For example, 10 full-time pharmacists now offer support to staff on all intensive care units.

The MGH's process for ordering, dispensing and documenting medications has undergone a number of changes as well. MGH Pharmacy played a critical role in the implementation of the electronic medication administration process for patient safety (EMAPPS), which was successfully completed this year. With patient medication profiling and EMAPPS in place, the pharmacist's role has changed. No medication can be accessed without approval from a pharmacist; previously, nurses could directly access medications from automated dispensing machines. To accommodate this added step, which ensures that the drug and its dosage are safe for the patient, over the last year, the pharmacy hired 10 full-time pharmacists. EMAPPS also increased the need to package and barcode medications for nurses to scan at the bedside. To support the increased reliance on computerization, a multidisciplinary team has been created to manage all of the software and hardware associated with the EMAPPS system.

While it continues to improve its on-campus services, the MGH Pharmacy is expanding to several ambulatory pharmacy outposts, including the Mass General/North Shore Center for Outpatient Care, the MGH Revere HealthCare Center, MGH West and the Yawkey Center for Outpatient Care's oncology services.

All of these changes are part of the MGH Pharmacy's continuous efforts to improve the services it offers. The department has created a strategic plan for the next few years and identified five core values: being essential to patient care; ensuring the accurate and timely delivery of all medications; being responsive to the needs of both patients and hospital staff; effectively managing resources; and ultimately, being a world-class department that sets the standard for quality and safety, research, and education.

The department soon will invite key customers and stakeholders to complete a survey regarding its core value performance. For information about the survey or the changes in the MGH Pharmacy and the hospital medication distribution system, contact Clapp at


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