For the clinical pharmacy staff at Keck Medicine of USC, the COVID-19 pandemic brought about changes in the way they interact not only with patients, but also with departments across the medical center. While clinicians and researchers are busy trying to find an effective treatment for the novel coronavirus, the clinical pharmacy team is busy behind the scenes, equipping doctors with needed prescription medications for patients both in and out of the hospital.

Krist Azizian, PharmD, MHA, chief pharmacy officer of Keck Medicine of USC, said the team at Keck Hospital of USC adapted to social distancing policies quickly and efficiently, allowing the pharmacists to meet safety requirements while also serving patients.

“I couldn’t be any more proud of our team; both the pharmacists and pharmacy technicians on the ground have adapted marvelously,” Azizian said. “They continue to show up to work and rotate through any shift as we need them to. They have definitely risen to the challenge and are working even more closely with our frontline physician and nursing colleagues.”

At USC Verdugo Hills Hospital, the inpatient pharmacy team was tapped to deliver and monitor critical medications alongside other frontline staff caring for COVID-19 patients. The transition was seamless, said Valerie Mesaros, PharmD, director of pharmacy services at USC-VHH.

“There is a fighting spirit and active sharing of knowledge across hospitals and amongst pharmacy colleagues, in collaboration with infectious disease physicians and intensivists, to provide the best COVID drug treatments that transcends beyond just USC,” Mesaros said. “We are here together for each other and our patients.”

The pharmacy teams also worked with the critical care and anesthesia teams to plan for current medication needs as well as to prepare for possible surges in patient needs. Jay P. Rho, PharmD, director of pharmacy services for Keck Hospital, found that the collaborations brought out the best in his colleagues.

“One of our earliest priorities as the COVID-19 crisis unfolded was to ensure critical care teams had immediate access to intubation medications while in isolation rooms,” Rho said. “I found working with the Anesthesia Department to create a rapid intubation airway kit to be a true collaborative process where both our departments showed creativity and mutual respect to assemble the most practical kit that would meet patient needs without wasting scarce resources.”

Azizian said he monitors medication supply daily and has kept up communication with pharmacy colleagues on the East Coast to develop a plan for increased medication needs. For example, intubated patients need more medication to sustain sedation, he said, which takes a toll on the available supply of medication. But the team developed prediction models to determine when medication needs will increase, as well as alternative protocols to preserve some of the most needed medications.

Along with the rest of the hospital, the clinical pharmacy teams also implemented telehealth practices into their routines. They’ve been meeting with patients virtually, such as those post-transplant who often need extensive education for what can be a complicated medication regimen. For the pharmacy team at USC Norris Cancer Hospital, this meant moving all possible meetings to telehealth. They also launched a team effort to protect both patients and health care workers with appropriate personal protective equipment (PPE) while continuing to provide care amid the pandemic.

“Our pharmacy team’s primary focus at USC Norris was to put processes in place to keep our vulnerable, immunocompromised patients safe without delaying or altering their treatment plans,” said Harry Shamamian, PharmD, MBA, director of pharmacy for the USC Norris Comprehensive Cancer Center. “We worked as a team to put together an extensive surge plan, which addressed scenarios for both increased census and decreased staffing due to illness. This exercise was especially important for our facilities as both our clinical and technical staff are highly trained and specialize in oncology pharmacy practice.”

For the students at the USC School of Pharmacy who had clinical rotations during the pandemic, Azizian said his team worked with the pharmacy faculty to develop virtual classes and allow the students to learn from actual patient records while maintaining patient privacy.

The investigational drug services team also was tapped to support research protocols that are being evaluated for treating COVID-19 patients, Azizian said, as well as to work with the hospital’s epidemiology and infectious disease teams to develop guidelines based on the newest research results.

— Melissa Masatani