Michaelle Dieuveuil prepares sterile epidural cassettes for patients in the Pharmacy Sterile Products Room.

Last year’s devastating hurricanes destroyed several key medical manufacturing plants in Puerto Rico, worsening existing shortages of critical medical supplies at hospitals across the country, including BWH and other Partners HealthCare institutions. At the same time, the Brigham is also among the thousands of health care organizations nationwide facing multiple medication shortages as U.S. drug manufacturers struggle to keep up with market demand.

The Brigham is currently facing a shortage of intravenous fluids (IV) and bags, as well as several frequently used injectable opioid medications. The Emergency Preparedness team, along with key unit leaders at BWH, have been meeting on a weekly basis for several months to actively monitor the situation and develop strategies for maintaining high-quality, safe care.

Charles Morris, MD, MPH, associate chief medical officer, has worked with the Emergency Preparedness team to address the shortages and described the crisis response as a “striking example of remarkable teamwork in action.”

“We’ve seen countless demonstrations of this collaboration. Materials Management pitches in to assist Pharmacy staff. The Information Services team provides real-time data about current supplies, allowing us to pinpoint areas of high utilization. Nursing staff works on implementing oral hydration strategies developed by Emergency Medicine faculty,” Morris said. “These efforts, along with so many others, have been truly collaborative.”

Mike Cotugno, RPh, director of Pharmacy Patient Care Services, has been involved in the many communications updating staff about the shortages and recommended solutions. Regularly partnering with care teams to work through any challenges, Cotugno said he is impressed every day by BWHers’ unrelenting support and patience.

“I’ve received dozens of emails from colleagues asking if there’s anything they can do to help,” Cotugno said. “They know how hard this has been for not only the Pharmacy team but also the entire hospital. There’s a lot of understanding, and everyone is supporting each other. It takes a team to get through difficult situations such as these shortages.”

Eric Goralnick, MD, MS, medical director of Emergency Preparedness, said it has been wonderful to observe various departments, professions and disciplines team up on a response to this longitudinal event. For example, pharmacists, responding clinicians and IS staff worked together to identify patients receiving IV fluids and an oral diet daily and explore opportunities to reduce IV usage.

“When events are prolonged, it is challenging to stay focused and maintain unity of effort,” Goralnick said. “We have so many committed professionals who are approaching these shortages by trialing new ideas, measuring their impact and changing practice in a new, improved way. We have also teamed up with Brigham and Women’s Faulkner Hospital and other Partners institutions on shared solutions. This is the model of how we need to combat similar events that require a multidisciplinary response.”

Each week, Katie Fillipon, MS, RN, OCN, FNP, associate chief nurse for Oncology and Medicine, has participated in calls with other members of the Emergency Preparedness team about the shortages. She agreed that shared decision-making within the working group has supported proactive changes that minimize any impact on patient care.

“Delivering high-quality, safe care is our collective priority, and being able to work alongside our Faulkner colleagues on these efforts has strengthened our commitment to supporting each other in achieving this, no matter what challenges we face,” Fillipon said. “There has also been a strong commitment to our communication strategy and a desire to ensure we provide information and decision support to our providers.”