HCA Healthcare Innovators Award: Financial Impact

Financial Impact Recipient: Mohammed Elayan, Pharma, BCOP, TriStar Centennial Medical Center, Nashville, TN

Tackling a large project takes smart planning and a specific set of goals to accomplish – along with a commitment to always moving forward. Mohammed Elayan, clinical pharmacist at TriStar Centennial Medical Center in Nashville, sees the opportunity in every challenge.

“I’ve always enjoyed the responsibility of contributing to the evolution of the practice of pharmacy,” he says.

Elayan came to TriStar Centennial Medical Center in August 2016 from Methodist Hospital in San Antonio, where he worked with Dr. Carlos Bachier, program director for blood and marrow transplant at Centennial. He quickly made a difference by developing a plan that would change how medications were administered to transplant patients — resulting in a significant cost savings with no change in patient care.

Chemotherapeutic agents like busulfan, melphalan and anti-thymocyte globulin are dosed via total exposure (the total dose the patient receives) prior to transplant. Unfortunately, the vials in which they are distributed contain more medicine than patients will need. That can mean several thousands of dollars are wasted each year.

“Many of the medications used in the field of oncology are very expensive – anywhere from $2,000 to $8,000 per vial,” Elayan says. “Each patient typically has a dose that’s tailored to them. We wondered if there was maybe a more optimal way to give the dosage.”

By staggering doses over the days the patient receives chemotherapy, multiple vials of these chemotherapeutic agents can be saved. More importantly, patients experience no additional toxic effects from the medication.

Elayan’s method has been implemented at Methodist Hospital and Sarah Cannon Cancer Institute at TriStar Centennial Medical Center in Nashville. He now hopes the new regimen could be implemented for all eligible patients across HCA Healthcare’s stem cell transplant network. Elayan acknowledges the team at Centennial for providing a collaborative environment — one that encourages ingenuity while inspiring employees to find powerful solutions that improve patient care.

“It’s easier to do things the way you’ve always done them,” he says. “Here, we are constantly challenging ourselves to improve and try new things. We hold each other accountable. I’m humbled to work with such a great team.”