The Subcommittee on Psychopharmacology is a weekly meeting of all prescribing psychiatric staff. The committee serves to support and educate psychiatrists in work with complicated and generally “treatment-resistant” patients. The committee offers participating psychiatrists an opportunity to present clinical and countertransference challenges and to benefit from an educational and transferential “Third” to the doctor-patient pair. The committee serves a peer review function, in evaluating the treatment of patients prior to Case Conferences in the light of the standard of care, institutional priorities, performance improvement, and the principles of psychodynamic psychopharmacology. The committee also focuses on risk management and serves to review negative outcomes and near misses, incorporating PI methodologies such as Fishbone and Failure Mode Effects Causal Analysis. The committee will work directly with patients and their prescribers, in order to address and ameliorate treatment impasses in psychopharmacology. The committee also serves as an opportunity to disseminate recent developments in psychopharmacology, including new evidence, changes in the standard of practice, and new drug warnings. The committee interfaces with other systems within the treatment environment, including the medical office, the nursing department, information technology, and the pharmacy. In these interdepartmental engagements, the committee explores and evaluates systems-based practices in the service of education and performance improvement.