Pharmacists, 

We are implementing a new alpha-gal workflow to streamline our process and ensure that only the appropriate patients are being identified for NDC checking. Our policy is being updated at P&T this month to reflect these changes, but pharmacists can use this new process now. 

- Allergy Clarification Process - Patients with confirmed or suspected AGS (a red meat or alpha-gal allergy is documented) will have their allergies clarified. Nurses will complete the Alpha-Gal Screening Powerform for patients in Pre-Admit Testing. For inpatients, pharmacists will review documented allergies/AGS via phone or in-person interview (see AGS Patient Interview Tip sheet) and document using the Alpha-Gal Screening Powerform in Cerner via AdHoc pharmacy intervention. This reflects the AGS Patient Interview Decision Tree. If a patient is in a procedural/perioperative area, pharmacists will complete AGS clarification AFTER the patient is moved from recovery to a nursing unit. 

- Medication Management (Inpatient) - Only patients with confirmed medication-related manifestations of AGS and a documented alpha-gal medication allergy, will have medication NDCs checked for inactive ingredients (see Inpatient Order Verification Process). Patients with mild allergies or intolerances to red meat, dairy, or gelatin and no known medication-related manifestations to AGS are documented as having a FOOD allergy and therefore do not require inactive ingredient medication screening. Alpha-Gal Safe Lists are also posted on FormWeb that will be updated quarterly by the Med Safety team to help pharmacists evaluate safe medications and/or NDCs in these patients with true a true AGS medication allergy.

- Medication Management (Perioperative) - Anesthesia staff will be provided the A-system Alpha-Gal Safe Medication List. The majority of high-use medications stocked in the A-systems are alpha-gal safe. Currently, anesthesia may request an alpha-gal tray for patients who's alpha-gal allergy has not been clarified. Once the new Intelliguard equipment arrives (hopefully February), the plan is that ALL anesthesia trays will be converted to "alpha-gal safe". Pharmacists will follow the Surgery Order Verification Process. 

All documents referenced in this email can be found on Formweb under the Alpha-Gal Syndrome page. Please let us know if there are any questions or concerns.