Implementation of a multidose ophthalmic medication policy change at a large health system

In response to a multidose ophthalmic medication (topical eye drop) shortage, the health system had to evaluate the current policy for multidose medications and propose changes to the policy to provide patient care while managing the drug shortage. The use of multidose eye drops on multiple patients is accepted in ophthalmology care per the Centers for Medicare and Medicaid Services updated guidance for ambulatory surgical centers. Before this, the use of multidose eye drops on multiple patients had not been in practice at our health system owing to contamination risk from repeated use in the preoperative setting. Given the ambiguity of the current policy with regard to multidose ophthalmic drop usage and the available literature, an updated policy was developed.

This report aimed to describe the evaluation, assessment, and implementation of a policy change supporting the use of multidose ophthalmic medications on multiple patients.

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

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

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.