Angus Kinkade is a clinical pharmacy specialist who works with the Medication Use Evaluation Team, dealing with the pharmaceutical supply chain through all of the lower mainland pharmacy services. Angus and his team used data-based predictions to avoid critical shortages of vital medications during the pandemic, as well as reformulating the usage of propofol here in B.C.

Behind every challenge of the pandemic stands a team of committed health care professionals at-the-ready with creative solutions to maintain patient care, no matter what their discipline.

One of those committed health care professionals is Angus Kinkade, a clinical pharmacy specialist.

Angus split his time between working with the Medication Use Evaluation Team and dealing with the pharmaceutical supply chain. His work supported all of the consolidated lower mainland pharmacy services in Fraser Health, Vancouver Coastal Health, Providence Health Care and the Provincial Health Services Authority.

When the pandemic hit and progressed, Angus was concerned about the potential consequences of how the drug supply could impact supportive care for patients.

“Even if we had ample ventilators available throughout the pandemic, without the right drugs this kind of supportive care would not be possible,” he says.

This inspired Angus and his team to prevent outcomes like that from happening by using data to create predictions for medication demand.

They worked diligently in the background, analyzing this data to inform how they could best manage medication supplies across the lower mainland.

Although Angus will humbly tell you he is simply an ‘ideas guy’, they were using cutting-edge innovations to make these important supply chain predictions.

“We used patient avatars based on their own ICU patient medication use evaluations and BCCDC modelling so we could predict drug requirements,” recalls Angus.

What did this mean for patients? It helped prevent critical shortages of vital medications like propofol.
Propofol is used for ventilating critically-ill patients who require sedation for ventilation in intensive and critical care units and is one of the World Health Organization’s essential medicines.

Angus, his team and their partners put their ideas into play early in the pandemic to secure these important medications.

“During a pandemic, a lack of propofol could be catastrophic and would have complicated our ability to ventilate critically-ill patients,” Angus reflects.

Another innovative idea was researching propofol formula use in other regions to see if a change would be effective here at home. He set to work with colleagues from several disciplines to change the formulary for propofol for lower mainland hospital pharmacies from the standard one per cent concentration used in Canada, to a two per cent concentration typically used in Europe with a more stable supply chain.

Doing so brought some risk. “A higher concentration of this medication without proper education could be dangerous,” Angus says. Their efforts worked and were so effective it paved the way for other health authorities in B.C. to follow suit.

Angus and his team are passionate about being good stewards of medication supply.

“We sometimes treat drugs like an infinite resource,” he says. “But they are not infinite. We are fortunate in Canada that we didn’t run out. Not all other nations have been as fortunate,” he explains.

“We need to ensure we have a reliable supply. The global nature of the pandemic meant we needed to be good stewards.”

Angus praises his team and highlights the importance of interconnectedness and partnership as we continue to face the pandemic. “No matter how seemingly small, our contributions to getting through this pandemic are all vital,” he explains. “For our system to function properly we all need to work together.”

Angus’s ideas, collaborative problem-solving skills and intense commitment to excellence in the delivery of pharmacy services and patient care have made him this year’s Above and Beyond winner for Service Delivery Excellence.

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