Redesign of P and T Committee functions and processes: A model

Rapid increases in drug expenditures and staff dissatisfaction with the P and T Committee prompted Parkland Health and Hospital System to undertake a redesign of its P and T Committee functions and processes in 1996. Along with ensuring greater front-line physician representation on the P and T Committee, the redesign expanded the committee's focus from cost containment to appropriate drug utilization to optimize outcomes and decrease overall treatment costs. This article discusses the four major components of the redesign - (1) streamlining P and T Committee-medical staff interaction, (2) instituting systems improvements to ensure quality in medication use, (3) broadening the scope of drug use evaluations, and (4) developing more balanced approaches to drug cost containment. The rationale behind these components are explained, and examples of specific initiatives and results to date are provided.