From the Field

Designing a Formulary That Works for Your Practice

Philippe Boutet DVM Director of Formulary & Supplier Quality Assurance, Banfield Pet Hospital

Dr. Boutet is responsible for leading a cross-functional team that reviews, selects and implements formulary items for Banfield’s more than 1000 hospitals nationwide, and works to ensure quality in the supply chain that supports them. Dr. Boutet earned his veterinary medicine degree from Université de Montréal, Faculté de Médecine Vétérinaire in Québec, Canada, and has worked in small animal practice for more than 10 years. He resides in Portland, Oregon, with his wife, two children and their boxer named Forrest.

Designing a Formulary  That Works for Your Practice
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From the Field shares insights from Banfield Pet Hospital veterinary team members. Drawing from the nationwide practice’s extensive research, as well as findings from its electronic veterinary medical records database and more than 8 million annual pet visits, this column is intended to explore topics and spark conversations relevant to veterinary practices that ultimately help create a better world for pets.

The veterinary industry continues to advance and accelerate medical research, bringing new formulary options to market and, in many cases, enabling elevated patient care.

As part of the largest general veterinary practice in the world, all of us at Banfield Pet Hospital feel an immense responsibility to deliver high-quality care—and products, whether vaccines, medication, or surgical supplies—to every patient that comes through our doors.

But while therapeutic choices usually mean good news for our patients and clients, we also know they can place additional stress on the shoulders of our veterinarians. So in this climate, how does a veterinary team help ensure the quality of its hospital formulary?

DETERMINE THE RIGHT MIX

First and foremost, outline the key categories of care that you provide within your clinic or hospital setting, while understanding that each layer added may increase financial investments in training and expertise, as well as in the suppliers required to provide that care.

A primary care provider’s needs differ from those of tertiary care providers, and their formularies should thus be different. From there, determine which items are considered “mission critical,” “core,” and “veterinarian/veterinary technician preference” for your practice. Bucketing products may help you prioritize order timing and frequency.

Be transparent about the choices you make as a team. When a consensus cannot be achieved, consider activating other channels, such as next-day delivery for special-use items or setting up a home delivery option for your clients.

SET SELECTION CRITERIA

At Banfield, we have also found that evaluating products within five areas of risk that are relevant for our clinical setting is an effective strategy. When evaluating a new formulary product or item, ask yourself the following questions within the 5 areas:

  1. Safe

Is the product or item category regulated (Food and Drug Administration [FDA], Environmental Protection Agency [EPA], U.S. Department of Agriculture [USDA]), and does it meet these standards? Does clinical evidence from a reputable source support the product’s safety for associates, patients, and clients?

  1. Effective

Are the product label’s claims supported by peer-reviewed literature? Was the item used in an applicable clinical setting similar to how or when you would use it? Were the desired or intended results reproduced in a validation study?

  1. Timely

Is the product or item readily available to the veterinary industry? Do alternates exist that may be a better option, since they are exclusively used in veterinary medicine? Are there backups in case of a shortage?

  1. Efficient

How will the addition of this product or item affect your veterinary teams? Is training required, and do you have systems in place to support its successful application?

  1. Quality

Has the product or item in question been recalled recently? Do any reports indicate the manufacturer has had issues in its quality-assurance processes?

KEEP YOUR FORMULARY CURRENT

Set a regular yet realistic formulary review cadence that works for you and your team. Consider breaking it up by popular categories of product and services, such as dental, parasiticides, vaccines, cardiology, renal, and dermatology.

Engage your whole team—from veterinarians to veterinary technicians to other paraprofessionals—and activate your resources. Work together, ask for help, assign roles and responsibilities, hold the team accountable to support patient outcomes, and create and foster a culture of safety along the way.

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