Formulary Reconciliation: Implementation of a Comprehensive Approach to Formulary Maintenance and Standardization

TL;DR

This paper describes a process to standardize and clarify medication formulary qualifiers to reduce confusion among healthcare staff.

Contribution

The study introduces a comprehensive approach to formulary reconciliation by standardizing categories and descriptions.

Findings

880 medications with formulary qualifiers were reviewed for standardization.

537 items had inpatient restrictions, and descriptions were updated for consistency.

Formulary reconciliation improved clarity and consistency for healthcare staff.

Abstract

At our institution UC San Diego Health, formulary qualifiers such as indication expansions and restrictions based on provider specialty, patient location, or patient characteristics are input as free text into an online formulary platform. Inconsistency in formulary categories and their descriptions since the implementation of the electronic system have led to confusion and inconsistent formulary application amongst staff. We reviewed 880 unique medications with formulary qualifiers to standardize both categories and language. There were 537 items with inpatient restrictions (eg, restricted to service), 147 items with a restriction to outpatient use only, 94 items with a formulation restriction, 91 items with associated guidelines, and 11 items with formulary expansions. Formulary status descriptions were updated to be consistent and clear. A standardized and well-maintained formulary, via formulary reconciliation, can provide concise and informative insight to the formulary status for frontline healthcare staff.

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