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DRUGS AND THERAPEUTIC COMMITTEE (DTC)

   1. Purpose

 A drug and therapeutics committee is a multi-disciplinary committee appointed by the Hospital Director General, which mainly aims at improving quality of patient care and health outcomes by: 

    • selecting effective, safe, high-quality, and cost-effective pharmaceuticals for the hospital;

    • improving of drug use, including antimicrobial use;

    • managing antimicrobial resistance;

    • increasing staff, patient and public knowledge about drugs,

    • decreasing adverse drug reactions and medication errors

    • Improving drug procurement and inventory management

    • Control and management of drug expenditures

2. Status

The drug and therapeutics committee is a committee appointed by the Hospital Director General. Its activities will be accountable to the Office of the Director General of the Hospital, whereby its chairman is responsible of those activities.

3. Organization

The Drug and Therapeutics Committee is a multi-disciplinary committee and therefore it shall be composed by members from medical and paramedical staff as well as from the administration. The committee will be constituted by the following core members:

  1. Medical Chief of Staff who is the Chairperson

  2. Head of Pharmacy Department, who is the Secretary

  3. Director of Nursing, Member

  4. Head of Anesthesia Unit or his representative

  5. Head of Laboratory Department or his representative

  6. District Pharmacist

    Each member of the committee will serve for a maximum of two years renewable once and departments could replace and may change their representative in the committee.

    The committee will assign a minutes’ keeper from the secretaries of the hospital. The minutes’ keeper will work closely with the secretary of the committee in organizing the minutes of the committee.

     

4. Duties and Responsibilities

4.1.Duties and responsibilities of the Committee

 

The DTC will have following responsibilities:

  • Prepare and conduct periodical review of the list of medicines and other medical commodities for the hospital with reference to essential drug list/national drug list.

  • Formulate recommendations to the pharmacy department in all activities related to the selection, quantification, procurement, distribution and dispensing of drugs and other medical commodities for the hospital.

  • Follow up the implementation of the National Standard Treatment Guidelines and Formulary to comply with the morbidity pattern observed in the hospital.

  • Develop a system of monitoring rational use of drugs in the hospital and make recommendations of its improvement.

  • Put in place strategies to contain antimicrobial resistances

  • Participate in preventing and managing nosocomial infections

  • Initiate and/or coordinate studies on problems related to rational use of drugs, proper distribution, and labeling of medications.

  • Elaborate mechanisms for the prevention and management of Medication Errors in the Hospital.

  • Serve as the decentralized unit of the National Pharmacovigilance and Medicines Information Center as per defined terms of reference of that decentralized unit in the Guidelines of Pharmacovigilance and Medicines Information.

  • Design and organize continuing educational programs regarding the promotion of rational drug use to medical personnel, other health workers and the public.

  • Participate actively in updating the National List of Essential Drugs, National Formulary and the National Treatment Guidelines.

  • Prepare its annual plan of action and budget and report its activities to the Hospital Health committee every quarter, with copies to the Hospital Managing Director.

  • Coordinate all activities related to pharmaceutical marketing by medical representatives in the hospital and other means of medicines promotion in accordance with the existing norms and regulations.

  • Evaluate its annual performance

     

    The Committee is responsible to make close follow-up of the implementations of its approved recommendations by the hospital management and the entire staff. If any staff does not implement the adopted DTC recommendations, the committee will discuss the recommendations with the staff again and urge the hospital management to take necessary measures.

     

     

4.2. Duties and Responsibilities of the Chairperson

The chairperson of the DTC will have the following responsibilities:

  1. Ensure the recommendations of the DTC are applied.

  2. Ensure that decisions of the committee are taken objectively and based on scientific evidence where applicable

  3. Establish good relationship between the committee and the management of the hospital

  4. Appoint an acting chairperson from the members if he/she is to be absent.

  5. Present quarterly activity reports to the hospital Health committee with copy to the Hospital Managing Director.

  6. Represent the committee in the Hospital Health committee meetings and other relevant events.

  7. Call regular and extraordinary meetings.

  8. Chair the meetings.

     

4.3. Duties and Responsibilities of the Secretariat

The secretary of the DTC will have the following responsibilities:

  1. In consultation with the chairperson, prepare the notice and agenda for all meetings and share them with all committee members at least seven days before the meeting.

  2. Prepare the minutes of all meetings together with the minutes keeper and disseminate these to all members.

  3. Follow up the action plan of the committee.

  4. Conduct literature searches and disseminate the material at least seven days before the committee meets.

  5. Ensure that the decisions taken by the committee are submitted to the Hospital Managing Director for his/her notification.

  6. Circulate all pertinent materials for meetings to all members and their task team at least one week before the meeting.

  7. Acknowledge the receipt of ADR reports.

     

4.4. Duties and responsibilities of a Member

Each member of the committee is responsible to:

  1. Actively participate in the DTC meetings and other activities

  2. Propose issues that need to be discussed

  3. Each member should give prior notification if he or she is unable to attend the next meeting.

     

    Any member who is absent in three consecutive meetings without any notified reason should be replaced

     

4.4. Duties and responsibilities of Pharmaco vigilance Decentralized Unit: Sub Committee of DTC

 

  1. This subcommittee will be built by four members:

    • One Doctor in Medicine who will act as President

    • The pharmacist of hospitals

    • The Chief of Nursing

    • One Supervisor of Health Facilities

       

  2. The subcommittee will ensure all activities related to pharmaco vigilance in his area of operation; these activities are:

  • Implement recommendations of the Guidelines for Medicines Safety Surveillance in Rwanda in health facilities within its catchment area.

  • Ensure the ready availability of the adverse event and medicine information request notification forms in all health facilities

  • Collect, validate and transmit all notifications and requests to National Pharmacovigilance and Medicines Information Center (NPMC)

  • Ensure that health workers are trained and are familiar with the completion of the notification forms

  • Using the platform of the DTC sensitize health workers on the need for medicine safety monitoring

  • Collaborate with the NPMC on a regular basis on all medicine safety related issues

  • Identify and develop proposals for the implementation of interventions to address all medicine safety and irrational use issues in health facilities within their catchment area

     

5. Meetings of the DTC

  • The DTC will meet every quarter then after and can have extraordinary meetings when necessary.

  • The committee may invite to its meetings persons within or outside the hospital who can contribute from their specialized knowledge or experience.

  • Issues to be discussed will be determined jointly by the chairperson and the secretary.

  • Agenda will be prepared and submitted to members of the committee in sufficient time before the meeting at least seven days before the meeting.

  • Minutes of the meeting will be signed by the chairman of the committee together with the secretary and be sent to the committee members for comments seven days after the meeting and be sent to the Accreditation steering committee then after.

  • Minutes shall be maintained in the secretariat of the hospital

  • Recommendations of the DTC will be presented to Hospital Health committee for adoption and implementation.

     

  • The quorum for any meeting is at least 50 percent of the membership of committee

  • DTC members can appoint punctual technical subcommittees for a specific task in their routine activities.

  • Correspondence will be addressed to the secretariat of the committee.

     

6. Motivating Members

The Health committee of the Hospital shall determine motivational mechanism(s) that can give equal chance for all members of the committee in conformity with existing norms.