Advocacy

The Pharmacy Enterprise at RWJBarnabas Health is an integrated part of the health care team. Pharmacists are responsible for ensuring safe, effective, and appropriate medication use for all patients.
  • Acute Care Service Line

The Acute Care Service Line consists of 451 pharmacists and 343 pharmacy technicians and more than 14 support staff. Our acute care pharmacy team is deployed both centrally and de-centrally. The inpatient decentralized model operates to verify orders on the patient care units, and attending rounds and counseling patients. The decentralized model is supported by computerized prescriber order entry (CPOE), automated dispensing cabinets (ADC) on the units, and bed-side barcode medication administration. Technicians support the decentralized pharmacists by restocking the ADCs and delivering non-stocked medications to the units from the central pharmacy. In the central pharmacy, the technicians assist pharmacists by answering phones, filling labels, compounding and picking medications, and performing deliveries. Centralized clinical pharmacists answer phones, verify orders, and oversee technician activities and IV room compounding.

In 2016 the Acute Care Service Line workload statistics include:

  • There were more than 32 million doses dispensed
  • The number of medication orders verified were nearly 4.5 million
  • The median turn around time to process a STAT order was 8 minutes
  • 12 minute median turn around time to process a routine order
  • The pharmacists performed more than 3.1 million clinical activities
  • The pharmacists performed in excess of 176,000 laboratory assessments
  • The pharmacy technicians performed more than 1.1 million activities
  • The team prevented more than 21,000 adverse reactions
  • The team intervened and prevented in excess of 60,000 medication errors from occurring
  • Performed greater than 28,000 Antibiotic Stewardship activities
  • More than 72,000 patients directly seen by a pharmacist
  • More than 2,500 vaccinations were administered by a pharmacist

Members of our team were named to national organization and editorial board leadership positions:

  • Chair of the Advocacy Committee for the Pediatric Pharmacy Advocacy Group
  • Chair of the American College of Clinical Pharmacy Code Committee
  • Chair of Section Advisory Group on Clinical Leadership for the American Society of Health System Pharmacists (ASHP)
  • Chair Elect of Advisory Committee for the Pediatric Pharmacy Advocacy Group (PPAG)
  • Chair of the American College of Clinical Pharmacy Emergency Medicine PRN
  • A member of our team was named to a chapter presidency for the New Jersey Society of Health System Pharmacist
  • Facilitated ASHP Ambulatory Care Informatics Section Advisory Group Networking Session at ASHP Mid-Year Conference
  • Appointed to ASHP Section Advisory Group on Ambulatory Care Informatics
  • Appointed to the National Home Infusion Leadership Board
  • Appointment to the ASHP section of Inpatient Practitioners Educational Steering Committee
  • Three of our teammates were named ASHP PGY1 Residency surveyors and an additional member of the team was named ASHP PGY2 Residency surveyor
  • Appointed to Board of Society of Critical Care Medicine
  • Appointed to NJ Dept. of HSS Medicinal Marijuana Panel
  • Appointed to NJ Dept. of HSS Osteoporosis Council

The RWJBarnabas Health Pharmacy Enterprise: encourages all teammates of all roles to pursue advanced certifications within their respective area of practice. These certifications are not required but are obtained by our teammates due to their self motivation to continuously improve their skill sets they offer our patients, and fellow practitioners.

Our team has received awards & recognition internally and externally for their exemplary work and leadership.

Certifications in 2016

  • Twenty-one members of the team achieved the Board Certified Pharmacotherapy Specialist distinction and three other teammates achieved further sub-specialty distinction in Critical Care and psychiatry. In addition, three other colleagues achieved certification from the Society of Infectious Disease Pharmacists and the American College of Clinical Pharmacy cardiology certification.
  • The RWJBarnabas Health Pharmacy Enterprise is proud of our teammates who have pursued these certifications and offer this expertise to our patients, families and fellow practitioners. In fact these practitioners are concentrated at RWJBarnabas Health. With 35% of all Critical Care and Psychiatry Board Certified Pharmacy Practitioners in the state of New Jersey are members of the RWJBarnabas Health Pharmacy Enterprise.
  • Sixteen of our pharmacy technician teammates have received board certification by successfully passing the Pharmacy Technician Certification Board exam.
  • Twenty-two members of our Pharmacist team successfully completed the American Pharmacist Association Pharmacy-based Immunization Delivery Certificate program which was facilitated by one of our certified teammates.
  • Twenty-four of our Pharmacist teammates attained the certification for Medication Therapy Management (MTM).

Internal and External Awards:

  • Best Student Poster at ACCP Virtual Poster Symposia
  • Core Value Award Newark Beth Israel Medical Center
  • Excellence in Caring Award
  • Employee of the Year Community Medical Center
  • Employee of the month Jersey City Medical Center
  • MARQUIS 2 Medication Reconciliation Quality Improvement Study from Society of Hospital Medicine
  • Medical Information: phactMI Leadership Award
  • New Jersey Society of Health System Pharmacist (NJSHP) 2nd and 3rd place poster winners
  • NJSHP Eric T Hola Research Grant
  • Society of Critical Care Medicine Research Award
  • Donald J. Wernick Academic Achievement Award at NJ APhA
  • Integrated Pharmacy Service Line

The Integrated Pharmacy Service Line consists of 43 pharmacists, 37 pharmacy technicians, 29 nurses and 44 support staff.

The Qualitas Home Infusion Division

The Qualitas Home Infusion Division consists of 21 pharmacists, 7 pharmacy technicians, 29 nurses and 24 support staff. The division delivers medications, nutritional support, infusion pumps and supplies as well as comprehensive education and infusion therapy management to patients in need of home infusion therapy

  • Our nurse colleagues performed nearly 18,000 home visits to our patients
  • The division made and administered in excess of 52,000 intravenous medications
  • Home infusion division achieved a 0.16 infection rate per 1,000 patient days
  • The Acute Care Service line referred greater than 1,000 patients to our service

The Qualitas Hospital Compounding & Repacking Division

The Qualitas Hospital Compounding and Repacking Division consists of 3 pharmacists, 8 pharmacy technicians, and 4 support staff. The division delivers medications, nutritional support, infusion pumps and supplies as well as comprehensive education and infusion therapy management to patients in need of home infusion therapy

  • Our pharmacy team prepared and delivered more than 101,000 intravenous medications for the Acute Care Service Line
  • There were in excess of 19,000 Total Parenteral Nutrition intravenous preparations made and delivered to our Acute Care Service Line
  • Our service repackaged for the Acute Care Service Line nearly 256,000 tablets of medications into unit dosage forms because they were not commercially available
  • Our service repackaged for the Acute Care Service Line more than 43,000 doses of liquid of medications into unit dosage forms because they were not commercially available

The Qualitas Mail Order Pharmacy Services

The Qualitas Mail Order Pharmacy Services consists of 2 pharmacists, 4 pharmacy technicians, and 5 support staff. The division delivers medications and provides superior service for RWJBarnabas Health employees and dependents, ensuring appropriate therapy.

  • Our mail order division filled more than 47,000 prescriptions for employees and their families.
  • The mail order division coordinated more than 36,000 medication deliveries averaging 195 prescriptions per day to employees homes.
  • The division filled nearly 16,000 340B prescriptions, averaging 74 per day.

The Qualitas Specialty Pharmacy Division

The Qualitas Specialty Pharmacy Division consists of 2 pharmacists, 5 pharmacy technicians, and 5 support staff. The division offers a unique service for transplant recipients. After transplant surgery, most patients require a large number of prescription medications to prevent rejection of their transplant and reduce the risk for infection. Our team maintains a consistent vigilance of transplant patient’s dosage changes and ensures patients maintain a careful medication regimen of immunosuppressive and anti-infective medications. The goal is to keep transplant recipients healthy and avoid rejection complications while maintaining the best patient outcomes.

  • Our dedicated team filled more than 69,000 prescriptions for our patients.
  • The team made in excess of 16,000 medication deliveries to our patients home
  • This division averages approximately 272 prescriptions on a daily basis
  • The Acute Care Service Line within our health system referred 356 transplant patients to our service.
  • The types of patients under our care are:
    • Heart Transplant
    • Hepatitis C
    • Kidney Transplant
    • Lung Transplant
    • Oncology

The Pharmacy Reimbursement Division

The Pharmacy Reimbursement Division (PRD) consists of a team of individuals with expertise in medication billing and reimbursement. The team is led by the Corporate Director of Pharmacy Systems Integration and supported by a Pharmacy Clinical Financial Analyst and a Pharmacy Reimbursement Specialist. All team members have a background in pharmacy either as a pharmacist or certified pharmacy technician.

  • Recovered over $7.4 million in 2016 for the Acute Care Service Line, through a dedicated review and incorporation of existing clinical, reporting and surveillance applications
  • Reviewed and ensured medication billing on over 4,700 billing, coding, charge capture and reconciliation activities
    • Resolved 200 Remedy tickets amounting to over 2700 actions
  • Additions/deletions/changes to billing set-up for formulary items
  • Quarterly and Annual medication HCPCS updates
  • NDC requirements submitted for Medicaid/Managed Medicaid claims
  • Payor, billing and reimbursement audits after go-lives
Improved medication charge recovery at non-Cerner areas (NICU, mental health, cardiac cath, OR, lab) Increased recovery of inpatient hemophilia reimbursement by 149% over previous year Implemented system drug replacement program and established a new workflow process for holds and reversals Monitored and facilitated the achievement of 2016 waste billing goals through the development and monthly analysis of actual billing versus waste opportunity for RWJBarnabas Health affiliates.

The Retail Pharmacy Network Division

The Retail Pharmacy Network Division consists of 14 pharmacists, 12 pharmacy technician, and six support staff. The retail pharmacists are responsible for dispensing and controlling medicine, which includes both prescription and non-prescriptions. They also advise customers on general healthcare. Retail pharmacists must work to legal and ethical guidelines set by many different regulatory agencies, including the State Pharmacy Board, Drug Enforcement Administration, Food and Drug Administration as well as payers.

  • Our team sold more than 138,912 prescriptions in 2016
  • The Retail Pharmacy Network Division is averaging 543 prescriptions filled per day
  • Our team filled nearly 58,000 prescriptions for our fellow employees averaging 226 prescriptions per day
  • The Retail Pharmacy Network Division filled more than 10,000 340B prescriptions averaging 41 per day.

In 2016, the retail pharmacies dispensed 138,912 prescriptions with a staff of 11 full time pharmacists. Employee prescriptions comprised 42% and non-employees were 58%. We also added the following additional services to our pharmacy network: 1) home delivery of prescriptions; 2) text message availability when prescription is ready for pick up; 3) QR code link for patients to have the availability of video medication counseling in both English and Spanish along with prescription refill reminder services.

To elevate the retail pharmacies, we added a shared faculty clinical position from Rutgers University, who is a trained and certified APhA Immunization instructor. In preparation for future programs, he trained 29 pharmacists within the Pharmacy Enterprise in the areas of CMS Star ratings, MTM and patient vaccinations. The faculty’s and APPE students provided free weekly blood pressure screenings at ACC retail pharmacy location and evaluated 356 people in 2016. From these screenings 20 individuals were found to have Stage II hypertension and referred to their primary care physician.

The pharmacy staff is also involved and actively participates in the weekly Multimodal Pain Program at Saint Barnabas Medical Center and provides detailed patient counseling as well as facilitation of our services. In the area of community outreach, the retail pharmacy has delivered numerous community outreach programs that include disease prevention, vaccinations, cholesterol education and Zika virus.

In 2016, the retail pharmacy employee program showed a decrease in revenue of $1.77M while prescriptions dispensed remained even. This is attributed to the decrease in fees as well as the conversion of brand to generic prescriptions in certain drug categories.

The retail pharmacies have also provided over $33K to employees for OTC discounts during 2016.

In 2017, the retail pharmacies enterprise goals are:

  • Moving CMMC retail pharmacy to their new location by the newly built entrance
  • Potentially looking at other retail pharmacy locations within our facilities
  • Adding language services to the pharmacy label which will be available in several different languages
  • Providing immunization services (Flu, Pneumococcal, TDAP, HPV, Herpes Zoster, Hepatitis B, and Meningococcal)
  • Possible expanding hours of operations at certain stores to include Saturdays

The 340B Drug Pricing Program Division

The 340B Drug Pricing Program Division consists of one pharmacist, two technicians and one support staff

THE 340B PROGRAM continues to meet its original goal of helping eligible patients and hospitals make the most of scarce resources while saving taxpayers money. The RWJBarnabas Health hospitals are committed to caring for the vulnerable and use 340B savings to stretch otherwise scarce resources. For patients, this means affordable medications, expanded access to community- based primary and specialty care, and help managing chronic conditions. This program supports all these benefits while reducing federal, state, and local health care spending. In fact, the 340B program saves dollars that otherwise would go toward indigent care.

Our programs provide much more. In addition to lower cost and affordable medications, it supports better care and better health outcomes, allow us to provide more services and offset losses from providing care without compensation.

At RWJBarnabas Health this program has grown substantially in 2016. Additions this year include Robert Wood Johnson-New Brunswick, Newark Beth Israel Medical Center – Hemophilia Treatment Center and the implementation of Saint Barnabas Medical Center starting in 2017.

  • The 340B team’s main focus in 2016 has been on elevating our responsibility to include auditing the hospital pharmacies, contracted pharmacies along with supplying compliance tools, 340B training and other support services.
  • The 340B audit team performed 205 individual audits in 2016 at five of our Disproportionate Share Hospitals and is posed to extend this oversight to our new entities.
  • Contracted Pharmacy is another area of oversight for this team. There are currently 134 of these pharmacies and we will be expanding to 198 in 2017.
  • A total of 9788 prescription claims were pulled and 389 underwent a Clinical Review in 2016.

As federal dollars shift and resources become scarce, it is critical that health centers participate in programs like this that will continue to increase patient access and expand services. The 340B program will enable health centers to increase access to affordable medication, which will ultimately improve outcomes, and assist in overcoming the impact of the decline in federal and state funding.

In 2017 we are concentrating our efforts on extending our reach to further assist all our 340B entities in maintaining and growing this program in a compliant manner to assist more patients.

Pharmacy Informatics Division

Pharmacy Informatics Division consists of 10 pharmacists, 1 pharmacy technician, and 1 nurse and 1 physician. The division oversees the management and optimization of the Clinical Information Systems for RWJBarnabas Health. Our Informatics Division made 2,100 safety enhancements to our health sys-tems Clinical Information Systems which serves as the foundation for all care providers when treating our patients.

Cerner and Siemens/Soarian Optimization (reviews, implementations and/or enhancements)

  • 10 PowerPlans/Subsets creation and optimizations completed
  • 13 separate order sets
  • 37 distinct Predefined Common Medications Order Sentences
  • 4 Clinical Pathways were completed
In 2016 a new vetting and change process was implemented with Medical Informatics Alerts Committee for pharmacy alerts. This group added and optimized alerts in areas such as:
  • Restricted Meds Alert
  • Anticoagulation and high risk medications
  • Ketogenic diet
  • Allergies
  • Duplicate Therapy
  • Stroke and Heart attack
The team made multiple enhancements within the Clinical Information Systems such as:
  • Multiple Powerforms were placed into the system
  • Created clinical task lists for pharmacists
  • Changed the medication format for multiple medications within the clinical information systems to increase safety, clinical effectiveness and avoidance of potential errors
The team was able to increase its support footprint and efficiency solutions for the health system through the following initiatives:
  • Pyxis ES conversion
  • PharmNet team acquired training on Soarian/Siemens to support JCMC
  • PharmNet team assumed and performed build/support/maintenance activities for Siemens/Soarian at JCMC
  • Reconfigured Pharmacy workflow cart fills and reports due to adding and closing of units
  • BCMC-wristband, medication and reports testing
  • Reconfigured Pharmacy workflow cart fills and reports due to adding and closing of units
  • Assisting and analyzing data to meet quality standards
  • Smart Pump implementation and maintenance
  • Healthcare Analytics – developed or revised Cerner (Explorer Menu, Discern Analytics, PowerInsight), MedeAnalytics and financial billing systems reports for acute care service lines
  • Creation of multiple job aids to guide teammates in the most efficient way to utilize enhancements that have been made to the information system
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