Julia Cartwright, R.Ph., Oncology Pharmacy Manager, has an intense, unceasing desire to know how things work in order to make them better. In her pharmacy, that means improving patient safety by making sure that chemotherapy drugs are prepared, delivered and administered using the safest and most efficient methods available.

Cartwright – who holds bachelor’s degrees in biology from Southwestern at Memphis (now Rhodes College) and pharmacy from the University of Tennessee Center for Health Sciences – came to Vanderbilt University Medical Center in 1985
to work in the general pharmacy.

Her transition to the Oncology Pharmacy, which prepares and distributes chemotherapy drugs to the entire medical center, came after volunteering there while she was still full time at the general pharmacy.

“I really loved working in oncology because of the attention to detail that was required, the safe handling requirements, and the scrutiny that orders needed from pharmacy which made the area really challenging,” she said.

Chemotherapy drugs orders are sent to the pharmacy, where staff members evaluate every known factor that could influence drug effectiveness, including all laboratory results and dosing regimens. The drugs are specifically mixed for each patient in a sterile environment underneath a vertical flow hood. The drugs are double-checked by a separate pharmacist and hand delivered to the appropriate clinic or unit to ensure safety.

After just a few short years in her new specialty, Cartwright became manager of the Oncology Pharmacy in 1989. Over her career, Cartwright has seen a paradigm shift in the way hospital pharmacies operate.

“When I started working here we didn’t have a computer system in the pharmacy at all. We did everything manually, from charging each and every dose of drug that was sent to the hospital patients, to typing labels on a typewriter.”

Since then, hospital pharmacies have developed automated medication retrieval, barcode verification systems, and advanced drug monitoring and dosing protocols, along with a huge array of software systems for integrating these processes. These new technologies improve patient care through automation and by allowing pharmacists to draw from the enormous wealth of knowledge accumulated in databases.

Cartwright recently spearheaded the effort to move the Oncology Pharmacy into a new, more efficient 1,600-square-foot space at The Vanderbilt Clinic, a move that allows the Chemotherapy Infusion Clinic to provide greater access to care.

The new space is twice as large as the old, and though the Oncology Pharmacy moved only this May, Cartwright had been thinking of what she would do with an expanded space for years.

“Working so many years in such tight space that is not very efficient, you start developing ideas about what would be really great if you had the space and you had to set it up,” she said.

One idea was the addition of an automated medication retrieval unit called MedCarousel, which increases patient safety by checking for accuracy through an advanced barcode system and database.

“I have always been interested in learning – a doer, not a ‘stand-back-and-watch’ kind of person,” said Cartwright. “I like to know how to fix my own problems so that I don’t have to wait for someone to come and fix them for me.”

Cartwright also maintains an active interest in research, overseeing and organizing nearly 100 new clinical trials each year. Over the past fiscal year, the Oncology Pharmacy prepared more than 47,000 chemotherapy doses – about 4,700 (10 percent) of which were investigational drugs. The increased space could allow the Oncology Pharmacy to conduct more clinical trials.

For Cartwright, managing the Oncology Pharmacy has provided a way for her to do something she is passionate about while
giving her an endless stream of novel experiences – new technologies, new investigational protocols, and now, a new facility.

“Every day that I come to work, I’ve learned something or I do something new. I’m not doing the same thing over and over again… I love what I do.”

– by Will Peters