Pharmacy faculty, alumni called on to shape Music City Center pandemic plans

Lipscomb’s pharmacy expertise tapped by the state to help prepare local community for the worst

Janel Shoun-Smith | 615.966.7078 | 05/15/2020

As the numbers of confirmed cases of COVID-19 in the U.S. began to climb in March, and Nashville and Tennessee began to prepare for the worst, Lipscomb University’s College of Pharmacy was there to make sure the local community was as prepared as it could possibly be.

College of Pharmacy faculty and Lipscomb alumni in the pharmacy field were among the first called on by the Tennessee Department of Health to help shape plans for a temporary overflow hospital in Nashville’s Music City Center.

Tennessee’s Department of Health Emergency Preparedness Director Paul Peterson contacted Dr. Micah Cost, executive director of the Tennessee Pharmacists Association (TPA) and a Lipscomb University alumnus, to engage local pharmacy professionals in planning for the emergency hospital.

Through the efforts of Cost and Dr. Lucy Adkins, TPA’s director of pharmacy practice initiatives, in early April, a pharmacy task force worked with the U.S. Corp of Engineers to create a plan for the possible Music City Center conversion to a 1,600 bed COVID-19 overflow facility. 

Included among the task force members was Dr. Kevin Hartman, a Lipscomb Academy and University alumnus and owner of NPS Pharmacy, a regional chain of pharmacies serving specialty care clinics, and Dr. Tom Campbell, dean of Lipscomb’s College of Pharmacy.

Hartman’s NPS Pharmacy was contracted as the manager of all pharmacy needs for Nashville’s emergency hospital, which included lining up all the vendors and partners to staff and equip the facility within a two-week time period, said Hartman. Within 48 hours of Cost’s call, Hartman was downtown meeting with a task force to address everything from food to construction, he said.

His company lined up vendors for everything pharmacy-related, such as ordering 50 critical care treatment carts deliverable within two weeks. Not an easy task, Hartman said. The task force considered logistical issues, walking through the facility to discuss where patient admission and initial assessments would take place, where medications would be stored, how they would be administered to each patient and how high-acuity patients would be kept separate from low-acuity patients, Cost said. 

“We came up with a logistical plan for a central pharmacy area, and then pharmacy staff would deliver medications to the nursing areas on rolling carts so they could be quickly accessible by nursing staff,” he said.

The pharmacists advised on ways to ensure that a patient’s medications they brought with them at the time of admission are known and recorded, so that proper medical decisions about drug interactions can be made later when new treatments are ordered, he said. Many patients would need medications for other conditions in addition to COVID-19, including controlled substances requiring specialized secure storage and management, which need to be considered in overall care.

“As the medication expert on the patient’s care team, having a pharmacist available to provide medication reconciliation services to patients upon admission and discharge is essential to optimizing outcomes and preventing medication errors. Since patients would be coming into the overflow facility from hospitals and other facilities from across Nashville and the Middle Tennessee area, each patient’s medication profile would consist of different medications. In some instances, patients could be admitted without having any medications in hand,” said Cost. 

Because the Music City Center was intended to be used as a 1,600-bed emergency facility for non-ICU COVID-19 patients, the pharmacist task force members had to think through how physician care was likely to be provided in a high-stress environment with many patients coming in the doors very quickly.

“The big concern was with the volume of cases that would be treated at the facility,” said Campbell. “We needed to think about how to optimize care with that many patients at once. In such a situation, the physicians would be struggling to obtain strong medical histories from patients, so the pharmacists could help augment that step in the process.”

The task force considered that student pharmacists could be a valuable part of the medical team if the plan was enacted, Campbell said. 

“This is a particularly unique learning opportunity for our students to experience firsthand a community’s response to a pandemic and to be a part of it through their work with local organizations who are in the middle of the response effort,” said Campbell.

“Pharmacists play a significant role in the health and wellness of a community and are on the frontline with patients during a time of crisis such as the COVID-19 pandemic we are experiencing now,” he said.

With Tennessee’s caseload projections trending down throughout April due to quarantine efforts, the city changed its overflow emergency plans to use Nashville General Hospital instead, a facility that could hold 500 beds.

Hartman’s company is still contracted to handle pharmacy services should the overflow hospital be put into use, he said.

“Going through this exercise, even though ultimately the (Music City Center) project was not needed,” was still a valuable venture, Hartman said. “We took the tack to say, let’s call in experts we know, to get the right team together. In the future, should some other crisis situation come up, we have gotten our feet wet on how to set this up in a fast period of time.”