The Department of Pharmacy at Houston Methodist Hospital (HMH) collaborates with the health care team to provide innovative, personalized, cost-effective pharmaceutical care in a culture dedicated to quality and safety.
The pharmacy department’s vision is to be recognized as a global leader of pharmaceutical care in the health care setting. To that end, we strive to:
•Continuously improve the quality and safety of patient care and the medication management process
•Cultivate an environment of collaboration and teamwork
•Provide high-quality training and education to our technicians, student interns, residents and pharmacists
•Maximize the use of automation and information technology
•Maximize cost efficiencies and resource utilization
MESSAGE FROM THE DIRECTOR OF PHARMACY SERVICES
Alex C. Varkey, PharmD, MS, FAPhA Director of Pharmacy Services
Houston Methodist Hospital
2024 – A Year of Resilience, Innovation and Excellence
As we reflect on 2024, we are filled with immense pride and gratitude for the incredible dedication of the Houston Methodist Hospital (HMH) Pharmacy Team. This year brought its share of challenges natural disasters, technological disruptions, and a rapidly evolving health care landscape but through it all, our team remained steadfast in our mission to provide unparalleled patient care. Our team members’ resilience, adaptability and unwavering commitment to excellence continue to define our department and elevate our profession.
Despite these challenges, 2024 was also a year of remarkable achievements. Houston Methodist Hospital maintained its position as the #1 hospital in Texas and secured a top-five ranking among academic medical centers in Vizient’s clinical quality and supply chain excellence cohort. Our department played a crucial role in these recognitions, driving innovation and setting new standards in pharmacy practice. We re-engineered a major component of our services with the launch of 24/7/365 Centralized Pharmacy Order Verification (CPOV), strengthened our virtual pharmacy capabilities, and continued to lead cutting-edge initiatives that enhance patient safety and operational efficiency.
Beyond the hospital walls, our pharmacy team members took on leadership roles in national organizations, earned prestigious awards, and shared our best practices on global platforms. Whether through the multiple Culture of Safety Awards, Good Catch recognitions, or contributions to professional workgroups, our impact is felt both within, and far beyond our institution. Additionally, Forbes recognized Houston Methodist as one of the Best Places to Work in Texas a testament to our commitment to fostering a supportive, innovative workplace.
As we look ahead to 2025, we are excited to build on this momentum. Our strategic priorities will focus on expanding virtual pharmacy services, optimizing onsite operations, advancing employee engagement, and leveraging technology to further highlight the invaluable contributions of our staff. Together, we will continue to set the bar for excellence in pharmacy practice.
To every pharmacist, pharmacy technician, student pharmacist, and support staff member thank you. Your dedication, passion, and teamwork make all the difference. We celebrate your accomplishments and look forward to another year of innovation, collaboration, and success!
Pharmacy Leadership Team
Pharmacy Leadership
Pharmacy Personnel
Recognized in 2024 for Years of Service
20 Years of Service
Aranzazu Calzado, Anh Cung, Ruben Demen, Melba Juanillo, Sheila Miller, Brian Parrish, Delia Rodriguez, Tera Rubio, Ellen Strapp, Cyrus Thompson
30 Years of Service
Norma Abassi, Robert Chapa, Anna Kiew Ho, Rene Martinez, Jillian Menifee
40 Years of Service
George Kurian, Rebeca Halfon, Lucila Martinez
New Hires
In 2024, the pharmacy department proudly welcomed an exceptional group of 44 new hires, bringing fresh perspectives, diverse expertise, and a shared commitment to excellence in patient care. Their contributions have already enriched our team and reinforced our dedication to advancing pharmacy practice.
Mahran Alassaf
Tiffany Chov
Carina Farag
Liliane Kheirbek
Carine Opsomer
Pharmacy Clinical Specialists
Kajohna Davis
Sara El-Koubysi
Payal Gurnani
Kevin Nguyen
Sylvia Stefanos
Catherine Vu
Pharmacy Technicians
Nathaly ChicasGonzalez
Jeziel Espinal Escobar
Taleshia France
Genesis Guzman
Noemi Lopez
Ali-Hussain Momin
Jacqueline Osugwu
Josie Renteria
Roxanne Roberts
Amanda Schoen
Boney Thankachan
Gabriel Torres
Fabio Triana
Brian Xue
Stephanie Zepeda
Employee Opinion Survey
Our Pharmacy Department recognizes that our employees are the foundation of our success. The annual Employee Opinion Survey is a vital tool to gain insights into our teams and identify opportunities for growth.
Since 2009, the Pharmacy Department has consistently ranked as a Tier 1 Department, achieving scores well above the national health care average in nearly every category.
Pharmacy Personnel
American Pharmacists Month
We celebrated American Pharmacists Month and National Pharmacy Technician Day throughout October. This month was dedicated to recognizing and appreciating the invaluable contributions of pharmacy professionals in enhancing patient care and ensuring medication safety.
$2,570 donated to Healthcare for the Homeless Houston Fundraising
2,200 meals and snacks provided Food
880 gifts distributed across the HM system Gifts
4 game winners and 5 raffle prize winners Activities
Community Outreach
The Department of Pharmacy participated in community outreach through a variety of events. Through Adopt-a-Family, the HMH Pharmacy department supported a six-memberfamily in need during the holiday season raising $1,430 in addition to purchasing many items off the family’s wish list. Many thanks to our Adopt-a-Family coordinators, Aranzazu Calzado and Niaz Deyhim.
Pharmacy also participated in I CARE in Action events hosted by the Houston Methodist Volunteering department that help the Greater Houston community. Our pharmacy residents and MILE interns volunteered with Rebuilding Together Houston, Houston Food Bank, and Memorial Assistance Ministries throughout 2024.
PEOPLE
Pharmacy Personnel Community Outreach
Houston Methodist Pharmacy Residents and Program Leaders showcased their commitment to service through I CARE in Action by partnering with Rebuilding Together Houston. In Crosby, Texas, the team repaired siding, built and sealed window frames, constructed a deck, and painted a house exterior. Their efforts improved the home’s appearance and provided meaningful support to a deserving community member, reflecting Houston Methodist’s values of compassion and dedication.
Residents visited the Freewheels Houston Bike Shop, an organization dedicated to repairing and distributing bicycles to refugees, helping them access work, school, and other essential services. During their time at the shop, the team worked diligently and successfully assembled a total of six bicycles entirely on their own. Their efforts contributed to empowering refugees with reliable transportation, making a meaningful impact on their daily lives and opportunities for success.
PEOPLE
Awards, Honors, and Recognitions
Beyond the Hospital Doors
Akraam Abdel-Kerem, PharmD, MS obtained Epic Willow Certification and appointed to ASHP Section of Pharmacy Information Technology
Atra Mouser, PharmD, MS appointed as TSHP New Practitioner Chair-Elect
Alexis Hyman, PharmD, MBA appointed as TSHP New Practitioner Member-at-Large
Niaz Deyhim, PharmD, MS, BCPS appointed as TSHP Management Section Member-at-Large, GCSHP President-Elect and to ASHP Value, Quality, and Compliance SPPL Advisory Group
Allison Wilson, PharmD appointed as TSHP Scholarship Judge/Reviewer
Chelsea Lopez, PharmD, BCCCP appointed as SCCM TX Chapter Awards Chair
Alan Luu, PharmD, MS, BCPS appointed as GCSHP Junior Director
Adam Smith, PharmD, MS, BCPS appointed to ASHP Business Development and System Integration SPPL Advisory Group
Linda Haines, PharmD, MS, BCPS appointed to ASHP New and Emerging Leader Section of Pharmacy Practice Leaders Advisory Group
Sunny Bhakta, PharmD, MS, BCPS appointed to ASHP Frontline Leaders SPPL Advisory Group
Kalina Korzec, PharmD awarded an ASHP Foundation Residency Research Grant
Greatest Catch Award
Karen Abboud, PharmD, BCOP
Good Catch Awards
Gina Cantu, PharmD
Karen Abboud, PharmD, BCOP
Roshni Tabermejo, PharmD
Akraam Abdel-Kerem, PharmD, MS
Alyssa Chaplain, PharmD, BCTXP
Chris Nelsen, PharmD
Aaron Hutchins, PharmD, BCTXP
Eric Rubido, PharmD, BCTXP
Aniefiok Eshiet, CPhT
Dequala Robinson, CPhT
Nicholas Palma, PharmD
Culture of Safety Awards
Unparalleled Safety Team RFID Crash Cart Location Tracking Team
Amanda Beck, PharmD, MS
David Putney, PharmD, MPH
Niaz Deyhim, PharmD, MS, BCPS
Haley Blanck, PharmD, MS
Unparalleled Safety Team – System Geriatric Context Clinical Decision Support Team
Andy Bui, PharmD, BCPS
Sunny Bhakta, PharmD, MS, BCPS
Alan Luu, PharmD, MS, BCPS
Alex Varkey, PharmD, MS, FAPhA elected as American Pharmacists Association (APhA) National President
PEOPLE
Awards, Honors, and Recognitions
Employee of the Year
In our eighth year of awarding a pharmacy department employee of the year, we were excited to present it to two individuals for 2024.
Parth Patel, PharmD has been an exceptional member of our acute care team, joining in 2022 as an overnight pharmacist. Since then, he has demonstrated exceptional flexibility and dedication by stepping in to support the clinical team, flexing to fill vacant positions as the department needs it. He regularly stays past his shift to ensure the best patient care and coordinates with pharmacies, insurance companies, and physicians for smooth medication transitions.
Mary Taylor, CPhT has been an integral part of our technician team, with over 40 years of service. She mainly supports the transplant team, offering unparalleled expertise in navigating relationships with outpatient pharmacies and with the transplant physicians. She uplifts team morale and ensures every member feels valued. Functioning as a leader, she consistently supports colleagues, mentor new team members, and contributes to a positive, collaborative environment.
Number of Publications by Pharmacy Service Line
8
7
1
5
1 Transplant Oncology Informatics & Administration Critical Care Infectious Disease
Publications
Transplant:
• Tu ZH, Pierce BJ, Pasley T, Hutchins A, Huang H. Immune outcomes of lung transplant recipients with different cytochrome P450 3A5 phenotypes after discontinuation of voriconazole antifungal prophylaxis. Clin Transplant. 2024;38(1):e15235. doi:10.1111/ctr.15235
• Fida N, Eagar TN, Yun AN, Rogers AW, et al. Effectiveness of combined plasma cell therapy and costimulation blockade based desensitization regimen in heart transplant candidates. Clin Transplant. 2024;38(2):e15249. doi:10.1111/ctr.15249
• Connor AA, Adelman MW, Mobley CM, Moaddab M, et al. Single-center Outcomes After Liver Transplantation With SARS-CoV-2-Positive Donors: An Argument for Increased Utilization. Transplant Direct. 2024;10(4):e1590. Published 2024 Mar 7. doi:10.1097/TXD.0000000000001590
• Tu ZH, Perez AD, Diaz TE, Loop MS, Clarke M. Safety and Efficacy of Direct Oral Anticoagulants vs Warfarin in Patients With Obesity and Venous Thromboembolism: A Retrospective Analysis. Tex Heart Inst J. 2024;51(1):e238260. doi:10.14503/THIJ-23-8260
• Tu ZH, Yun AN, Gorthi J, Guha A, Krisl JC, Bhimaraj A. Terbutaline for Management of Relative Bradycardia Post-Orthotopic Heart Transplant: A Single Center Experience. Clin Transplant. 2024;38(11):e70036. doi:10.1111/ctr.70036
• Pasley T, Baladad C, DeSear K, et al. Bridging Echinocandin With Azole Antifungal Therapy on Prevention of Invasive Candidiasis Post-Lung Transplantation. Open Forum Infect Dis. 2024;11(9):ofae525. Published 2024 Sep 11. doi:10.1093/ofid/ofae525
• Yun AN, Rogers AW, Krisl JC, Kagan A, Adrogue HE, Khan AJ, Khairallah P, Yi SG, Hobeika M, McMillan R, Podder H, Gaber AO, Knight RJ. Plasmapheresis and Rituximab for Prevention of Focal Segmental Glomerulosclerosis Recurrence Post-Kidney Transplantation. 2024. Transplantation Direct. DOI: 10.1097/TXD.0000000000001769
• Patel K, Tu Z, Guha A, Gorthi J, Yun A, Krisl J, Kassi M, Kim J, Yousefzai R, Ghobrial M, Gaber O, Bhimaraj A. Five Years Post Heart Transplant Outcomes in Patients with Amyloidosis: A Single Center Experience. 2024. Circulation. DOI: 10.1161/circ.150.suppl_1.414416 Critical Care:
• Farrar JE, Stefanos SS, Cava L, et al. Correlation Between Serum and CSF Concentrations of Midazolam and 1-Hydroxy-Midazolam in Critically Ill Neurosurgical Patients. Ann Pharmacother. Published online August 20, 2024. doi:10.1177/10600280241271130
• Halawi H, Harris JE, Nguyen DT, Graviss EA, Putney D, Kassi M. Impact of statins on incidence of gastrointestinal bleeding events among patients with continuous-flow left ventricular assist devices. Int J Artif Organs. 2024;47(11):826-835. doi:10.1177/03913988241286437
• Halawi H, Sabawi MM, Rizk E, et al. Bleeding outcomes in critically ill patients on heparin with discordant aPTT and anti-Xa activity. J Thromb Thrombolysis. Published online October 5, 2024. doi:10.1007/s11239-024-03048-0
• Abdulla A, Donahue KR, Hall C, Culver LG, Morton C. Incidence of Venous Thromboembolism Post-Oral Anticoagulation Reversal in Intracranial Hemorrhage Patients. Ann Pharmacother. Published online November 19, 2024. doi:10.1177/10600280241297701
• Abdulla A, Rezvani A, Nelsen C, Sigala MI. D-Penicillamine Induced Myelotoxicity: A Unique Case. Journal of Pharmacy Practice. 2024;0(0). doi:10.1177/08971900241308626
Oncology:
• Gong Z, Umoru G, Monge J, et al. Adverse effects and non-relapse mortality of BCMA directed T cell therapies in multiple myeloma: an FAERS database study. Blood Cancer J. 2024;14(1):36. Published 2024 Mar 5. doi:10.1038/s41408-024-01023-9
• Allen E, Brown EN, Torre R, Murthy A. Retrospective study on the efficacy and tolerability of dose modification of PD-1 and PD-L1 inhibitors in hospital-system community outpatient cancer clinics. J Oncol Pharm Pract. 2024;30(3):507-512. doi:10.1177/10781552231177209
• Chung C, Umoru G. Prognostic and predictive biomarkers with therapeutic targets in nonsmall-cell lung cancer: A 2023 update on current development, evidence, and recommendation. J Oncol Pharm Pract. Published online April 5, 2024. doi:10.1177/10781552241242684
• Abboud K, Umoru G, Trachtenberg B, Ajewole V. Real-world data of cardio-oncologic interventions for cardiovascular adverse events with oral oncolytics. Cardiooncology. 2024;10(1):22. Published 2024 Apr 9. doi:10.1186/s40959-024-00221-5
• Yazji A, Brown EN, De La Torre R, Umoru GO. Immune checkpoint blockade effect on immunologic and virologic profile of five cancer patients living with human immunodeficiency virus (HIV) infection. J Oncol Pharm Pract. 2024;30(7):1249-1254. doi:10.1177/10781552241264258
• Karimi S, Abboud K, Umoru G, Bernicker EH. Effect of direct oral anticoagulants compared to enoxaparin on objective response to immune checkpoint inhibitors in patients with lung cancer. J Oncol Pharm Pract. Published online December 5, 2024. doi:10.1177/10781552241303992
• Poon IO, Ajewole V, Braun UK. A Review of Olanzapine in the Treatment of Cancer Anorexia-Cachexia Syndrome. Pharmacy (Basel). 2024;12(1):34. Published 2024 Feb 17. doi:10.3390/pharmacy12010034
Infectious Disease:
• Finch NA, Granillo A, Pouya N, Bhimraj A, Miller WR, Tam VH. Pharmacokinetics of cefiderocol in a patient with carbapenem-resistant Acinetobacter baumannii ventriculitis: A case report. Pharmacotherapy. Published online December 4, 2024. doi:10.1002/phar.4632
Administration/Informatics:
• Deyhim N, Adeola M, Bhakta SB. Evaluation of barcode-assisted medication preparation technology for liquid medication doses. Am J Health Syst Pharm. Published online November 9, 2024. doi:10.1093/ajhp/zxae339
PEOPLE
Educating Tomorrow’s Health Care Leaders
Pharmacy Technician Training Program
Through the department’s partnership with Houston Community College, we provided seven students with valuable pharmacy technician training to support their education and the growth of the workforce.
Summer Observership
Two pharmacy students joined us for a sixweek experience at Houston Methodist. During this time, they shadowed and participated in patient care, medication management, and hospital operations.
Summer Administrative Internship
The administrative internship offers students practical experience in a professional office setting, where they assist with a variety of tasks to ensure the efficient operation of the organization. This year, we thank Guilherme Hilgert for his hard work and dedication.
Pharmacy Student Training
This year, we hosted eight IPPE (Introductory Pharmacy Practice Experience), 37 APPE (Advanced Pharmacy Practice Experience), and 18 Lebanese American University learners, to gain valuable experience in a hospital pharmacy setting.
LAPPE
In 2024, seven LAPPE (Longitudinal Advanced Pharmacy Practice Experience) students joined us for robust clinical and administrative rotational experiences in our hospital pharmacy. They also had the opportunity to work on research projects, all of which were presented at the Midyear Clinical Meeting.
Power Week
Our department hosted HMH Power Week where pharmacy students across the state of Texas joined us for our week-long shadowing program. This year, we had 36 amazing students participate, making a total of 293 participants since the start of this program in 2017.
PEOPLE
Educating Tomorrow’s Health Care Leaders
Pharmacy Residency and Fellowship Programs
Since 1987, Houston Methodist’s pharmacy residency and fellowship programs have been preparing pharmacy graduates with the expertise and skills essential for leadership in pharmacy practice and research. By integrating educational, practical and research experiences, Houston Methodist equips residents and fellows to excel and lead in the evolving landscape of health care.
Houston Methodist Postgraduate Pharmacy Residency & Fellowship Class 2023-2024
PEOPLE
Pharmacy Olympics
In 2024, the Pharmacy Olympic Games brought our team together with an international potluck, and exciting games, including a Telephone Relay, Olympic Trivia, Ultimate Rock-Paper-Scissors Tournament, and Archery. This event celebrated teamwork and camaraderie of diverse cultures in a fun-filled day.
2024 ended with 9,377,344 doses (21.3% increase from 2019) sent from our pharmacy teams. This growth highlights how our department has adapted to increasing demands while maintaining a high standard of patient care. 7,565,386 7,140,532
From 2019 to 2024, our dispense volume has continued to rise with our unit of service (equivalent patient days).
SERVICE
Medication Distribution
Medication Dispenses by Location
Since 2015, we have expanded utilization of Pyxis automated dispensing cabinets to improve medication turnaround time for critical patient care initiatives.
In 2024, we saw medication dispenses from Pyxis remain the same as 2023 at 74%. In November 2024, a significant operational shift started with decommission of robot utilization for cartfill doses, with products being transitioned to carousel systems. This transition reflects a continued focus on optimizing workflows and resource utilization.
Operational Data and Metrics
Order Verification Turnaround Time
The pharmacy department is committed to expeditiously and safely processing all medication orders (average 5,500/day) from the time of receipt to availability. With the implementation of 24/7/365 Centralized Pharmacy Order Verification (CPOV) services in early April 2024, our hospital was able to see an overall average decreased turnaround time for both routine and stat medication orders. CPOV is now responsible for verification of >90% eligible orders as evidenced by the graph below.
Breakdown of Order Verification Completion
Operational Areas
Central Pharmacy Operations
Central Pharmacy Day Operations Team
Central Pharmacy Night Operations Team
The central pharmacy operations team ensures the accurate preparation, verification, and distribution of medications to most inpatient patient care areas including the ED.
Our team’s daily responsibilities include compounding sterile and non-sterile medications, managing inventory, and coordinating delivery of medications to automated systems (e.g. Pyxis ).
Dose Distribution and Operational Support
1.2M doses dispensed from medication carousel technology
400,000+ Epic medication messages managed
Provision of 230,000+ compounded sterile products
89,000+ calls received in Central Call Center
300+ electronic prior authorizations approved
200+ environmental assets are monitored across the hospital including refrigerators, freezers, and warmers
137,000+ oral syringes prepared using barcoded medication preparation technology
92% of doses dispensed were marked received via iOS Rover tracking
Operational Areas
Controlled Substance (CS) Vault Team
The CS Vault team ensures the secure management, distribution and compliance of all controlled medications within the hospital.
CS Doses Dipsensed from Pyxis
2024 Accomplishments
strategies Revamped the physical CS inventory process
Streamlined HMH and LTAC replenishment processes
Refreshed the CII Safe inventory Developed electronic forms for the CS Vault team
Operational Areas
Walter Tower ICU Satellite Pharmacy
The ICU satellite pharmacy operates 24/7 and primarily serves five ICUs (medical, surgical liver, neuro, cardiovascular, and cardiac) and one IMU. Key functions of this satellite pharmacy is to provide timely review of medication orders to be prepared and dispensed to our critically ill patients.
Annual Dispense Volume
There have been efforts to decrease waste of pharmaceutical products while increasing efficiencies with ready-to-use products in addition to loading items in Pyxis machines.
COVID-19 Pandemic
Operational Areas
ED Satellite Pharmacy
The Emergency Department (ED) satellite pharmacy performs medication histories for patients admitted from the HMH Main Emergency Department. This team also provides medication support to three community Emergency Care Centers (Kirby, Voss and Pearland).
Over the past three years, there has been a steady increase in the medication histories completed by pharmacy for patients admitted through the ED, even as admission volumes increased. With the launch of Centralized Pharmacy Order Verification (CPOV) in April 2024, workflow modifications were made to allow for additional pharmacy support.
Pharmacy Completed Medication Histories in ED per 1,000 Admissions
Operational Areas
Perioperative Pharmacy Services
The perioperative pharmacy services team operates six different pharmacy satellite locations throughout our seven procedural suites at HMH. The average number of medications administered in HMH procedural spaces in 2024 was over 74,400 per month.
2024 marked the complete transformation from manual to automated dispensing within the operating room with full implementation of Pyxis Anesthesia Stations in all procedural suites.
The oncology operations team is in the Outpatient Center tower on the 22nd floor. The OPC22 primarily services the inpatient and outpatient hematology/oncology patient population but also supports all non-oncology outpatient infusions, including advanced microbial vector therapies and specialized treatments.
Our dedicated team primarily caters to the needs of both inpatient and outpatient hematology/oncology patients, ensuring they receive the highest standard of care. In 2024, the OPC 22 pharmacy provided patient care services to 23,481 encounters. New referrals to oncology specialty services comprised of over 11,000 patients.
2024 Achievement Highlights
Introduction of a hybrid pharmacist role
Go-live of the Loccioni Apoteca Chemo Robot, with monthly capture of ~20% preparations
Workflow integration of Epic Dispense Preparation
Deployment of the RxCrush specialized pill-crushing system
2024-2025 USP <800> refresh
Streamlining terminal cleaning
Development of technician specialist roles for staffing support
Implementation of Epic Compounding and Repackaging process with image capture
Operational Areas
Outpatient Center (OPC) Satellite Pharmacy
Dispense Volume by Area
2024 Total Dispense Volume
57,406 total doses dispensed
22,000+ hazardous doses dispensed
Loccioni Apoteca Chemo Robot Metrics
Pharmacy’s Impact on Service Lines and Patient Throughput
Clinical Pharmacy Services Data & Metrics
Clinical Pharmacy Consult Data Summary
In 2024, the clinical pharmacy team completed more than 51,000 pharmacy consults related to patient care. The pharmacy department documented over 7,000 interventions that supported hospital discharges with transitions of care measures such as medication reconciliation and prior authorization.
The pharmacy department completed approximately 48,000 medication histories for patient encounters. The majority of this activity is performed by the medication history team of pharmacists and technicians in the emergency department.
Top 10 Consulted Pharmacy Services in 2024
•Renal
•Heparin
•Apixaban
•TPN
•Vancomycin
•Medication Reconciliation
•Warfarin
•Medicare Shared Savings (MSSP)
•Rivaroxaban
•Bivalirudin
Antimicrobial Stewardship & Infectious Disease
The Antimicrobial Stewardship & Infectious Disease Clinical Pharmacy Team participates in improving patient outcomes for various infections. Their efforts enhance patient safety, support seamless transitions of care, and contribute to ongoing education and policy development.
ID Clinical Pharmacy Team
Clinical Pharmacy Services
Cardiology Clinical Pharmacy Services
The Cardiology Clinical Pharmacy Team plays a vital role in optimizing many high-risk medications for patients with cardiovascular conditions. Leaders in pulmonary hypertension, antiarrhythmics and anticoagulation, they work collaboratively with the cardiologist to optimize patient therapy and outcomes. This year, they focused on leading medication safety initiatives and regulatory compliance with Risk Evaluation and Mitigation Strategies (REMS).
Expanded support to pulmonary hypertension service line
Led two FDA REMS audits for compliance
Anticoagulation clinic services through collaborative practice agreements for LVAD patients
Cardiology Clinical Pharmacy Team Not Pictured: Brian Parrish, May Achi
Critical Care Clinical Pharmacy Services
The Critical Care Clinical Pharmacy Team provides expert medication management to support the critically ill. Working with the ICU intensivist, they help to optimize vasopressors, antibiotics, and sedation strategies. An essential part of the Code Blue committee, they respond to every code throughout the hospital. Through policy development, interdisciplinary collaboration and rapid response support, this team continues to improve patient outcomes in critical care.
ICU Clinical Day Shift Pharmacy Team Not Pictured: Diane Dreucean, Luma Succar
ICU Clinical Night Shift Pharmacy Team
ED Clinical Pharmacy Services
This year, our clinical pharmacy services in the HMH Main Emergency Department were enhanced by transitioning to a rotational model with two pharmacy clinical specialists. This change ensures a clinician is present for extended hours, seven days a week.
ED Clinical Pharmacy Team Not Pictured: Kajohna Davis
Internal Medicine Clinical Pharmacy Services
The Internal Medicine Pharmacy Team ensures safe, effective medication use for most of our hospitalized patients. Working with the hospitalist and primary teams, the Internal Medicine Pharmacy Team works to optimize medications for the patient’s transition back home. They focus on enhancing the discharge process implementing a new strategy for patient education through artificial intelligence, to obtain prior authorizations and the reconciliation of medications as the patient returns home.
Post-Acute Care Clinical Pharmacy Services
The Post-Acute Care Pharmacy team includes Houston Methodist’s Long-Term Acute Care (LTAC), Skilled Nursing Facility (SNF) and Rehab areas. This team prioritizes medication management for patients who require extended care. They focus on chronic disease management and transitions of care support. They collaborate with many interdisciplinary teams to continue high-quality pharmacy services across post-acute settings.
Post-Acute Care Clinical Pharmacy Team
Not Pictured: Kim Ngo
Integrated service with solid organ transplant specialty
Transitions of Care services for all patients
Quarterly ASP-HMCCH meetings to promote stewardship efforts
Oncology & Bone Marrow Transplant
This year, the Oncology & Bone Marrow Transplant Clinical Pharmacy Team expanded its impact through successful creations of collaborative practice agreements. They contribute to developing treatment plans for numerous patients, enhancing personalized patient care. The team focuses on appropriate chemotherapy while strengthening safe and effective care.
Oncology & BMT Clinical Pharmacy Team
Not Pictured: Eleanor Hobaugh
Two collaborative practice agreements
Optimization of inpatient versus outpatient chemotherapy infusions
Centralized treatment plan order entry
Palliative Care & Pain Management
The Palliative Care & Pain Management Clinical Team plays a key role in optimizing pain regimens. Their efforts for safe practice use of opioids continue to expand across the Houston Methodist health system.
SERVICE
Solid Organ Transplant
The Solid Organ Transplant Clinical Pharmacy Team provided expert service to support a high volume of organ transplants, ensuring safe immunosuppression, infection prevention, and adherence counseling. At Houston Methodist, we are the #5 transplant program in the nation and this team contributes to the expansion of services and enhancing the transplant success for each patient.
Surgery Clinical Pharmacy Services
This pharmacist team helps with post-surgery care for patients including transitions of care considerations, outpatient prescription coverage, medication education, and post-surgery pain management. They are key for monitoring fall risk due to pain medications and postoperative changes in the patient. They also support discharge reconciliation processes with the hospitalists to ensure safe transitions home.
QUALITY & SAFETY
Medication Use Safety, Policy and Quality Assurance
1
21 Failure modes and effects analysis (FMEA)
15 Continuous quality improvement (CQI) projects
CMPI Great Catch Award Pharmacy Recipients
11 Medication safety policies developed and/or updated
>1,700
Medicationrelated event reports reviewed
5 Student and resident rotations
In 2024, the Medication Safety Team led and collaborated on many initiatives to improve patient care, including:
• Medication History and Reconciliation Process Improvement project in collaboration with the HMH Quality and Safety Team
• Aligning Pyxis override settings with system policy and ISMP recommendations
• Optimizing patient care intervention categories and implementing non-patient care intervention types
• Incorporation of EpiPen auto-injectors into select care areas
• Review and updates to anticoagulation pharmacovigilance rules
• Removal of non-NDC barcode scanning to minimize risk of errors
• Insulin glargine pilot in ED Pyxis
• Local Anesthetic Systemic Toxicity (LAST) education in collaboration with nursing
• Promethazine order updates to align with new labeling
• REMS audits
• DNV corrective action team
• Creation of vesicant/irritant and light protected medication reference documents
• Glycemic control projects resulting in creation of HMH DAC for 2025
• Numerous BPA and order set creations and modifications
QUALITY & SAFETY
Medication Use Safety, Policy and Quality Assurance
Pyxis Override Removal Rate
In 2024, the HMH Pharmacy Department continued its commitment to enhance medication safety by further reducing the Pyxis override rate. Building on previous efforts, strategic initiatives led by operations, the Medication Safety Committee, and the Controlled Substances Diversion Prevention Team, there was a focus on improving controlled substance overrides as well as non-controlled medications. This year, all medications followed a declining trend in override rates, reinforcing our ongoing efforts for medication safety practices.
Barcode Medication Administration (BCMA)
The HMH nursing and pharmacy teams work together to achieve and maintain BCMA compliance above 99%.
QUALITY & SAFETY
Medication Use Safety, Policy and Quality Assurance
New Event Reporting Platform
In Fall 2024, the HM System launched the PressGaney High Reliability Platform (HRP) to strengthen its commitment to fostering a Just Culture This enhanced patient safety event reporting while retaining the familiar internal name, TAPS (Transparency and Accountability in Patient Safety), while introducing several key improvements These include a more user-friendly reporter form, advanced analytics and reporting capabilities, and improved two-way communication
Security Policy
In alignment with updated security protocols, all non-pharmacy employees are now required to sign in when entering pharmacy locations within the hospital. This policy ensures a safer and more secure environment by tracking access and maintaining control over who enters sensitive pharmacy areas. In addition, comprehensive Code Silver action plans were drafted for all pharmacy areas.
Pyxis Anesthesia Stations (PAS)
A strategic initiative in 2024 was to increase electronic tracking and visibility of medication use from Pyxis Anesthesia Stations in OR spaces. In 2024, we realized this goal through successful conversion of all operating and interventional radiology rooms to PAS. This implementation included a remarkable 107 stations across seven procedural suites. Additionally, we expanded medication access by installing Pyxis MedStations in key operating room core areas.
Perioperative Pyxis Stations
QUALITY & SAFETY
Medication Use Safety, Policy and Quality Assurance
Controlled Substance Diversion Prevention Program (CSDPP)
In June 2024, the Controlled Substance Diversion Prevention Program (CSDPP) Team introduced ControlCheck , a cutting-edge analytics software designed to enhance controlled substance management. ControlCheck enables 100% closed-loop reconciliation by auto-reconciling approximately 97% of all controlled substances using dispense, administration, and waste data, with the remaining 3% requiring manual review.
In addition, the OR pharmacy team has implemented a structured controlled substance auditing process within the procedural areas. The CSDPP Team has collaborated with Anesthesia Leadership on several controlled substance-related initiatives throughout the year, including 100% of waste retrieval from procedural areas for PharmID testing.
2024-2025 CSDPP Committee Members:
Executives: Gail Vozzella and Jeff Carr
Anesthesia: Dr. Randy Steadman and Dr. Derek Schoppa
Nursing: Terry Clark, Matthew Freeman, Daniel Kerr, Kathryn Materre, Susan Teer, Travis Tingle, Blair Gerken, Nikolas Ellis, Ashley Eugene, Emma McClellan
POWER WEEK
Business Practices: Julie Lewis
Security: Robert Gomez
HR: Andrew “Drew” Taulton and Edda Tinis
Employee Health: Maisie Mok
Risk Management: Charlotte James
Pharmacy/CSDPP Team: Linda Haines, Angela Blueitt, Theresa Miller, Michell Nguyen, Tatjana Ramos, Alex Varkey, Atra Mouser, Sarah El-Koubysi
Pharmacy IT: Emmanuel Njigha
Quality & Safety: Vidya Saldivar
Accreditation: Karen Ward
Daily discrepancy notifications and resolution
Appropriate wasting
Security of controlled substances
Daily reconciliation of EPIC vs. Pyxis with follow-up emails
Weekly Pyxis controlled substance inventory
Monthly proactive diversion detection
CSDPP activities
2024 CSDPP Committee Members
2024 CSDPP Accomplishments
• 53 Investigations Completed
• Implemented Control Check Drug Diversion Monitoring Software
• Reduced Inappropriate Returns of Controlled Substances by 21%
• Added Controlled Substance Alert to MAR Entries
• Implemented Anesthesia Controlled Substance Reconciliation Epic Functionality in EHR
• Presented “Lighting the Way” Controlled Substance Continuing Education at International Health Facility Diversion Association (IHFDA) Conference
• Developed & Implemented Controlled Substance Management and Diversion Prevention LMS
Training, Audit Process for Pyxis
Anesthesia, and Audit Process for Override Cancel
QUALITY & SAFETY
Medication Use Safety, Policy and Quality Assurance
Methodist Internship Longitudinal Experience (MILE) Program
The MILE Program is an exclusive three-year opportunity available to a select number of highly qualified students in the second semester of their first professional year of pharmacy school. The first two years of the internship focus on learning the intricacies of pharmacy operations and leading longitudinal pharmacy initiatives under the mentorship of department leaders. The final year of the internship transitions into clinically focused activities and longitudinal projects.
Starting in 2024, interns had the opportunity to apply for the MILE Informatics Track, which offers voluntary educational lectures and hands-on assignments led by the Pharmacy Informatics team. This track provides practical experience in pharmacy informatics through topic discussions and practice exercises. This selective program is in tandem with their existing intern responsibilities.
QUALITY & SAFETY
Medication Supply Chain
Pharmacy Drug Shortage Management
Pharmacy intervention plays a crucial role in managing drug shortages, focusing on identifying alternative therapies, implementing strategic purchasing to prevent supply disruptions, and ensuring fair resource allocation. Pharmacists also enhance communication about drug shortages within the health care team and with patients, utilizing Electronic Health Record (EHR) systems to guide prescriber behavior through soft and hard stops These interventions are essential in maintaining patient care quality and safety during drug shortages, reflecting the indispensable role pharmacy personnel play in navigating care.
Select Drug Shortages Managed
Finance Performance
Operating Expense
The Department of Pharmacy’s actual operating expense for 2024 totaled $374.2 million against a flex budget of $397.5 million and a fixed budget of $366.9 million.
$460,000,000
$410,000,000
$360,000,000
$310,000,000
$260,000,000
$210,000,000
$160,000,000
$110,000,000
$60,000,000
$10,000,000
In 2024, the pharmacy department experienced a notable increase in total drug charges from $3.625 billion in 2023 to $4.263 billion, demonstrating a continuous increase in recent years. Revenue $-
$4,500,000,000
$4,000,000,000
$3,500,000,000
$3,000,000,000
$2,500,000,000
$2,000,000,000
$1,500,000,000
$1,000,000,000
$500,000,000
$100,000,000
$50,000,000
• Initiatives include a Pyxis par optimization and outdate tracking project aimed at reducing product that expires out of Pyxis machines
Other initiatives
FINANCE
Technology & Quality Control (TQC) Operations
The TQC Team
The Technology & Quality Control (TQC) Team plays a pivotal role in ensuring costefficient medication management by focusing on various insourcing initiatives. Their efforts have been pivotal in addressing the IV fluid shortage across the system.
IV Fluid Shortage Mitigation
• 9,100 units of split bags (NS and LR)
• 1,600 units of irrigation (NS 3 L)
• 1,000 units of ACD/D10W
System/HMH Shortage Mitigation
• Viscous 2% Lidocaine
• Gabapentin Oral Solution
• D50% Syringes
• Aluminum Hydroxide/Simethicone
• Nystatin
Strategic Growth and Support Outcomes
Service Enhancements
• Installed 2 iPACKS to allow decommission of EOL PharmoPack from BD
• Converted HM System to Pantoprazole Liquid IP Suspension
• Launched EPIC Willow Inventory System Inventory Requests for all entities Regulatory
• Implemented revised USP 795 and 797 standards – PPE and cleanroom renovations 2025 Goals
• Rapid Sterility Testing
• Reduce medication waste
TQC Pharmacy Team Members
INNOVATION
Pharmacy Technology & Research
Innovation Through Investigational Drug Services
The Investigational Drug Services (IDS) Team supports clinical research by ensuring safe, compliant and efficient management of investigational drug. They collaborate with various investigators and regulatory bodies to advance clinical research at Houston Methodist.
81 Protocols were Opened
62 Protocols were Closed
30% Study Turnover Rate
206 Current Open Studies Managed by IDS Pharmacy
2,915 Investigation Prescriptions Dispensed in 2024
IDS Pharmacy Team Members
INNOVATION
Pharmacy Technology & Research
Innovation Through Research
Each year, the Department of Pharmacy conducts over 20 research projects with our pharmacy residents to evaluate opportunities to improve in the care of our patients.
Information about each of these projects can be found in the Department of Pharmacy Annual Research Reports. Additionally, over 20 continuous quality improvement (CQI) projects are conducted by our residents each year.
External visibility during 2024 produced an amazing demonstration in outreach from our department:
• Celebrated 20 publications from the pharmacy department
• Represented 11 poster presentations at national meetings
• Delivered 23 platform presentations at national and local organizations
• Elected to 16 committee or board positions
• Served as judges in 2 competitions
• Taught 6 lectures at various colleges of pharmacy
• Provided expertise in 3 manuscript reviews
Pharmacy Research Committee
INNOVATION
Pharmacy Technology & Research
Medication Processing Robot
The Medication Processing Robot is collaborative technology capable of leveraging barcode scanning to sort medication for timely reuse.
Robotic assisted workflow for medication return management will increase the return to inventory stock at a faster rate and reduce the need to repurchase medications.
The integration of this robot into the pharmacy operations workflow will commence in early 2025.
Cold Storage Inventory Management
In 2025, the pharmacy department will integrate the Swisslog Refrigerated Boxpicker® solution to revolutionize cold storage inventory management.
This advanced system is designed to optimize the storage and retrieval of temperature sensitive medications. The Boxpicker’s automated features will allow for streamlined operations and enhanced efficiency.
A LOOK AHEAD TO 2025
2025 Strategic Plan Initiatives
This upcoming year, we want to emphasize a comprehensive, patient-centered approach to pharmacy services while embracing innovation. The three main themes for strategic initiatives in 2025 are:
(1) develop efficiencies through the integration of automation and technology into workflow,
(2) increase pharmacy’s impact on patient throughput and safety metrics, and (3) improve employee engagement.
• Initiate additional training sessions for pharmacists and technicians
• Provide more integration between various clinical teams
• Expand cross-training of pharmacy technicians to additional operational areas
People Service
• Create new workflows and audit processes to optimize dispensing and delivery times of medications
• Develop centralized clinical care and operation models to improve efficiency
• Expand to an additional cleanroom in central pharmacy
• Increase and expand stock dose syringe process and advanced preparation due to advanced labs
Quality & Safety
• Implement controlled substance quality checks in the procedural area space
• Develop regulatory body audit preparation toolkits with resources
