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Blake Barlow

Massachusetts General Hospital

Blake BarlowMassachusetts experienced its first patient with confirmed COVID-19 in early March 2020. Shortly thereafter, the Massachusetts General Hospital (MGH) admitted its first patient affected by the disease. The number of inpatient cases grew rapidly, and after two months MGH finally experienced peak numbers on April 23: 355 inpatients testing positive for COVID-19, 161 of which were admitted to the intensive care unit (ICU) setting. Due to the number of COVID-19 patients requiring ICU-level of care, MGH added 130 new ICU beds to the existing 114 ICU beds by converting existing general medicine and PACU units.

Because of the acute surge in ICU beds, the MGH Department of Pharmacy needed to appropriately increase ICU-level pharmacy coverage without compromising existing patient care areas. Seeing this need, our PGY-1 pharmacy residents began to selflessly volunteer on an individual basis to remove themselves from rotation and cover ICUs full-time. PGY-1 volunteers who had at least one previous ICU rotation were asked to cover the new COVID ICUs, while residents who had two or more previous ICU rotations were asked to assist with coverage of legacy ICUs.1 The PGY-1 resident volunteers were placed with experienced critical care clinical pharmacists for a period of 1-2 weeks to train prior to staffing independently in the ICUs on a daily basis. In addition, the PGY-1 health-system pharmacy administration and leadership resident was tasked with tracking utilization of all critical medications related to COVID-19 to share daily with pharmacy leadership, ensuring the Department of Pharmacy was able to meet the increased demand of key medications.

The clinical coverage provided by our PGY-1 residents in the COVID and non-COVID ICUs was critical to patient safety and clinical optimization. The healthcare team relied heavily upon our pharmacy residents to serve as resources for drug information, order verification, and drug therapy monitoring. In addition, our clinical pharmacists and pharmacy residents were key in communicating drug shortages and assisting with transitions to alternative therapies (e.g., transitioning patients from IV hydromorphone drips to IV fentanyl drips).

MGH’s clinical response to the COVID-19 peak was dramatically impacted by our pharmacy residents who volunteered to staff full-time in the COVID and non-COVID ICUs. Without our residents, it would have been exceedingly difficult to provide adequate pharmacy clinical coverage to all patients due to the acute increase in patient volume at MGH.

Blake T. Barlow, PharmD, MBA, is a PGY-2 health-system pharmacy administration and leadership resident at Massachusetts General Hospital.

  1. Uchida, E. et al. Rising to the Challenge: Pharmacy Residents on the Frontlines during COVID-19 Pandemic. Am J Health Syst Pharm. 2020. Advance online publication.



Posted April 1, 2021