Implementation of a multi-dose ophthalmic medication policy change at a large health system.

Abstract

Background: In response to a multi-dose ophthalmic medication (topical eye drop) shortage, the health system had to evaluate the current policy for multi-dose medications and propose changes to the policy to provide patient care while managing the drug shortage. The use of multi-dose eye drops on multiple patients is accepted in ophthalmology care per the CMS updated guidance for ambulatory surgical centers. Prior to this, the use of multi-dose eye drops on multiple patients had not been in practice at our health system due to contamination risk from repeated use in the pre-operative setting. Given the ambiguity of the current policy with regards to multi-dose ophthalmic drop usage and the available literature, an updated policy was developed.

Objectives: The objective of this report is to describe the evaluation, assessment, and implementation of a policy change supporting the use of multi-dose ophthalmic medications on multiple patients.

Methods: Key stakeholders met and assessed the impact of the shortage and potential policy needs. After evaluation of available literature and regulatory guidance, the proposed change was brought through the necessary formulary, safety, and policy channels for review.

Results: After review of the available literature, a determination was made that there is sufficient support of the practice to use multi-dose eye drops in multiple patients provided there are appropriate infection control guidelines. The policy edits were approved by the appropriate committees, and subsequently the organization's policy oversight committee.

Conclusions: Our organization was able to make a substantial policy change through a collaborative, interdisciplinary review of literature and best practices to address a critical patient care need resulting from a medication shortage.