The pharmacy helps support the medical staff as they offer the most efficient pharmaceutical care. In addition to centralized and decentralized services, clinical pharmacists serve as sources of drug information and medication management while ensuring safe medication practices for clinicians and patients.

Academic

The Department of Pharmacy Services dedicates a major effort in educating future generations of pharmacists. In addition to our American Society of Health-System Pharmacists-accredited Pharmacy Practice Residency Programs, the Department is also affiliated with the Arnold and Marie Schwartz College of Pharmacy and Health Sciences at Long Island University and Touro College of Pharmacy. Faculty members from the College of Pharmacy have their practice at the hospital to coordinate and precept student clerkships. Every year, approximately 40 pharmacy students rotate through clinical areas at Mount Sinai, and are exposed to different areas of pharmacy practice, including drug distributions, clinical services, and administration. The College of Pharmacy faculty members are also part of the clinical pharmacy service team and provide clinical services to medicine teams and their specialty therapeutic area. Occasionally, pharmacy students and residents from other pharmacy schools and institutions also elect to spend part of their educational experience at Mount Sinai.

Antibiotic Assistance Program/PK Monitoring

The Antimicrobial Assistance Program (AAP) was created in July 2005 at The Mount Sinai Hospital to promote the rational, safe, and cost-conscious use of antimicrobials. The primary goal of the program is to optimize clinical outcomes while minimizing unintended consequences of antimicrobial use, such as drug toxicity, selection of pathogenic organisms, and emergence of antibiotic resistance. The secondary goal of the program is to reduce health care costs without adversely impacting quality of care.

The AAP consists of three full-time clinical pharmacists with specialties in Infectious Diseases, as well as a dedicated Infectious Diseases Attending Physician. The activities of the AAP generally include the daily approval and review of the selection, dosing, route, and duration of therapy of restricted antimicrobials. The AAP is also responsible for developing policies and guidelines for the use of broad-spectrum antibiotics, and reviewing new antimicrobials for formulary consideration.

The AAP works closely with Infection Control and the Division of Infectious Diseases in evaluating the impact of antibiotic use on the incidence of antibiotic resistance in the hospital. The AAP is also involved in educating the pharmacy and medical staff.

Investigational Drug Service

The investigational drug coordinators support the medical school and the hospital in the vast field of clinical research. We review all investigator-initiated trials and sponsor-driven protocols that involve medications. Along with the staff in the Ambulatory and Inpatient Pharmacy, the clinical pharmacists oversee the dispensation and storage of investigational agents. The coordinators also serve as the liaison between the Department of Pharmacy and the Institutional Review Board (IRB). In addition, our Oncology Research Coordinator serves on the Protocol Review and Monitoring Committee (PRMC) and a pharmacy representative is part of the Data and Safety Monitoring Board (DSMB).

Drug Information/Drug Policy

Drug Information Center

The Department of Pharmacy maintains a formal Drug Information Center. The Center provides information regarding pharmacotherapy and other issues that relate to the use of medications in order to assist health care providers in treating and educating patients. In addition, clinical pharmacists are available for pharmacotherapeutic consultations with medical, nursing, and other related professional staff.

The Drug Information Center is well equipped with abstracting services, textbook resources, and a number of computerized literature retrieval systems. These resources make it possible to provide the professional staff of Mount Sinai Hospital with up-to-date information in many areas, including:

• Investigational or foreign drugs
• Therapeutic alternatives 
• Pharmacodynamics
• Pharmacokinetics
• Adverse drug reactions
• Toxicology
• Drug compatibility
• Drug-drug, drug-food, and drug-disease state interactions

The Drug Information Center provides services Monday to Friday, between 9:00 a.m. and 5:00 p.m. Those requiring immediate assistance may page the Drug Information Coordinator, leave a message on the Phone Mail system, or call the Inpatient Pharmacy.

Adverse Drug Reaction Reporting Program

The Department of Pharmacy maintains a formal Adverse Drug Reaction (ADR) reporting program for all healthcare professionals affiliated with The Mount Sinai Hospital. In order to improve patient outcomes, healthcare professionals from all disciplines and services are encouraged to report any suspected ADRs that may occur. The collected data is evaluated for severity, causality, patient outcome, and hospital-wide trending. When required, information is submitted to state and federal agencies for further analysis. All patient and reporter information is kept confidential.

Medication Use Evaluation

The Department of Pharmacy Services conducts continual assessments of patient outcomes through medication use evaluation and disease state management across all age groups. The review of medication use and disease state management is coordinated by the Medication Safety Director, with input from other appropriate professionals when necessary. Corrective action and educational programs are also provided where appropriate.

Medication Safety

The Department of Pharmacy has worked closely with the Executive Vice President's Office for Excellence in Patient Care to develop a Medication Safety System. This system alerts pharmacists to potential drug related problems. All medication safety activities are carried out according to Institute for Safe Medication Practice (ISMP) recommendations, Food and Drug Administration (FDA) alerts, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards, and literature reports.

Oncology

The primary role of the clinical oncology pharmacist is to serve as a clinical liaison between the Hematology/Oncology Department and the Pharmacy Department. This responsibility includes all matters that pertain to chemotherapeutic agents; reviewing formulary drug requests, developing hospital guidelines on medication utilization, providing drug information to medical and pharmacy staff, and actively participating in daily medical rounds.

Transplant

The solid organ transplant pharmacist supports the Recanati/Miller Transplantation Institute (RMTI) and the Advanced Therapies team within the Heart Hospital at Mount Sinai Hospital. The RMTI and the Heart Hospital are dedicated to the care, research, and education of patients undergoing solid organ transplantation. The RMTI performs both adult and pediatric transplantation of the following organs (individually and in combination): liver, kidney, pancreas, and small intestine, and the Heart Hospital provides advanced mechanical support including ventricular assist devices and total artificial hearts, as well as adult and pediatric cardiac transplantation. Pharmacy services include all aspects of pharmaceutical care for patients of the RMTI and cardiac transplantation services including daily rounds with the multidisciplinary transplantation team, reviewing formulary drug requests, practitioner and patient education, research, and providing drug information to medical and pharmacy staff.