Establishing a therapeutic drug monitoring consultation service.

A formal therapeutic drug monitoring consultation service (TDMCS) will enhance the clinical benefits of drug level determinations. It can result in decreased length of stay and improved risk management posture. The successful implementation of a TDMCS requires the coordinated efforts of a multidisciplinary team that may include physicians, pharmacists, nurses, and laboratory personnel. Clinical pathologists and clinical pharmacists are particularly well qualified to direct a TDMCS. Consistent delivery of quality services requires that all procedures related to the consultation process be standardized and documented in a procedures manual. The cost of providing the service may be recovered through both direct and indirect mechanisms.