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Am J Health Syst Pharm . Insights on developing a field hospital formulary and medication distribution process in preparation for a second surge of COVID-19 cases

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  • Am J Health Syst Pharm . Insights on developing a field hospital formulary and medication distribution process in preparation for a second surge of COVID-19 cases


    Am J Health Syst Pharm


    . 2020 Jul 24;zxaa232.
    doi: 10.1093/ajhp/zxaa232. Online ahead of print.
    Insights on developing a field hospital formulary and medication distribution process in preparation for a second surge of COVID-19 cases


    Brian Bazzell 1 , Deb Wagner 1 , Karin M Durant 1 , Brian Callahan 1



    Affiliations

    Abstract

    Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
    Purpose: The coronavirus disease 2019 (COVID-19) pandemic has caused health systems across the country to plan for field hospitals to care for patients outside of traditional healthcare settings in the event of a second surge. Here we describe key considerations for the implementation of pharmacy operations and a field hospital formulary at an offsite location within a 2-week time frame.
    Summary: Development of an offsite field hospital formulary is first dependent on the location and patient population defined for the field hospital. Creation of a limited formulary for a planned field hospital in Michigan involved reviewing physical space limitations and drug distribution workflows, assessing current prescribing trends, creating drug categories, and creating formulary guidelines to limit formulary options in each therapeutic category. Ultimately, our institution developed a 140-medication field hospital formulary, a process to enable appropriate use of nonformulary drugs, and a mixed operations model including automated dispensing cabinets and a manual cart-fill process. Although the institution did not have to open the field hospital, the process used for developing the formulary and determining distribution models will allow for an immediate implementation if a second surge occurs.
    Conclusion: A methodical approach to developing limited formularies and pharmacy operations in a field hospital setting will allow health systems to establish efficient and effective medication distribution services in the event of a second surge of COVID-19 cases.

    Keywords: alternative care center; coronavirus; drug distribution; field hospital; formulary; pharmacy operations.

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