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Ruchira Kumar

Beth Israel Deaconess Medical Center

Ruchira KumarI primarily staff in the central inpatient pharmacy with a strong focus on pharmacy operations. Alluding to the team-based model approach that exists within our department, I am often referred to as being the pharmacist equivalent to the quarterback in football.

My primary role involves ensuring that the accurate medications are delivered in a timely manner for all patients on the nursing units. I also triage workflow within the pharmacy between our decentralized pharmacists, IV staff, and pharmacy technicians to assist in having sufficient supply of high-use medications readily available on hand.

Many commonly used medications, such as ketamine, hydromorphone, fentanyl, norepinephrine, and phenylephrine, were on manufacturer backorder. Given the complexities of drug therapies for patients with COVID-19, there were different strengths of intravenous medications being ordered. With unavailable commercial supply, it was essential for me to coordinate compounding using various formulations available. Many of our existing medicine-surgery and outpatient units were converted to intensive care units to handle the surge of patients. To that end, we installed additional automated dispensing machines in those areas to accommodate the volume of ICU-specific medications needed for care. It was essential that these machines had accurate and adjusted par levels of all medications depending upon the volume of patients being treated.

Our technician staff had to be deployed to refill medications to these added areas and I was responsible for overseeing their new workflow. With the unknown severity of this novel virus, there were different precautions that were taken to ensure the safety to our staff. To prioritize medication access throughout the institution, we utilized our pneumatic tube system to efficiently get medications to the unit. We disinfected all tubes as they came through the pneumatic tube system to ensure cleanliness. Similarly, any medication that was brought back from any unit in the hospital was also disinfected prior to being returned to inventory. This was a new procedure to incorporate into our already busy daily practices.

The central pharmacy is the backbone for all other pharmacy operations in the institution. We were tasked with rapidly redesigning workflow and supplying the necessary medications to care for the surge of patients with COVID-19. We were able to succeed with flexibility, communication, creativity, and leadership.

Ruchira Kumar, Pharm.D., is a clinical pharmacist at Beth Israel Deaconess Medical Center.  


Posted April 1, 2021