Clinical Pharmacist - Ambulatory Care

The University of Iowa Health Care, Department of Pharmaceutical Care, is seeking a full-time Clinical Pharmacist to join our team.  The Ambulatory Care Clinical Pharmacist provides pharmaceutical care to patients seen in UI Health Care Ambulatory Care Pharmacies. The pharmacist provides clinical support, education, dispensing and monitoring of patients receiving medications through UI Health Care Ambulatory Pharmacies, immunizations and may include infusion services. The Ambulatory Care Clinical Pharmacist will serve as a role model for other Department of Pharmaceutical Care staff, residents, and students who look to improve their own professional capabilities and level of services, particularly in the provision and expansion of ambulatory pharmacy services.

Position Responsibilities:

Provides Therapeutic Drug Monitoring (TDM) on clinic-administered medications and take-home prescription orders.

1. Completes a comprehensive patient assessment which includes evaluation of the patient’s medications, and an evaluation of the patient’s medical history.
2. Evaluates all prescription orders to ensure the appropriateness of the following:
   • Indication for use
   • Dose
   • Route of administration
   • Drug interactions
   • Dose adjustments for organ dysfunction
   • Physical and therapeutic incompatibilities
   • Drug-induced side effects and adverse reactions
   • Potential drug misuse or abuse
   • Use of the most cost-effective therapy
   • Duplicate therapy
3. Ensures pharmacokinetic assessment of drug dosing on targeted patients through:
   • Clinical assessment of patients and desired therapeutic endpoints
   • Preparation of formal dosing recommendations
4. Communicates with prescribers about patient medication needs.
5. Conducts review of patient profiles and updates as needed based upon findings at time of patient visit.
6. Provides appropriate drug information to other healthcare professionals.
7.  Assesses drug allergies noted in the medical record.
8. Participates in collecting and documenting medication histories on patients.
9. Evaluates patient compliance with prescribed medication therapy and identifies problems that may lead to partial or noncompliance.
10. Utilizes appropriate resources and coordinates the resolution of financial concerns/burdens with department financial counselors. 

Documents All Patient Care Activities Performed

The clinical pharmacist provides pharmacy-related services through sharing of information with other members of the healthcare team via documentation within the patient medical record and other on-line reporting systems.  Examples of documentation may include:

1. Patient drug allergies and patient-specific height and weight information
2. Medication histories.
3. Medication counseling to patients.
4. Interventions with prescribers and other healthcare providers.
5. Patient interactions – those that occur in the clinic and when the patient is located elsewhere (e.g., at home, as an inpatient, in the Ambulatory Care Pharmacy).
6. Drug dosing recommendations made to prescribers.
7. Drug Use Evaluation Program activities.
8. Steps taken to identify, evaluate, or avoid adverse drug reactions. 

Coordinates Patient Communications and Interactions

The clinical pharmacist educates patients on the pharmaceutical care services offered including the following:

1. Medication history.
2. Patient’s drug allergy history.
3. Patient teaching classes (where appropriate).
4. Medication counseling.
5. Communicating patient information to local healthcare providers involved with the patient’s care to ensure appropriate continuity of care. 

Facilitates Operational Initiatives Which Lead to Enhanced Patient Care Services

The clinical pharmacist assumes the role of patient advocate for all concerns associated with drug therapy.  The clinical pharmacist shall position him/herself to positively influence therapeutic decisions which will affect patients and their care.  Participation in hospital-wide programs intended to improve care (e.g., the Drug Use Evaluation Program and Adverse Drug Reaction Reporting Program) serves as a valuable quality-of-service surveillance tool and promotes healthcare provider education.

1. Follows-up on any medication system problems, such as:
   • Unclear or inappropriate prescription orders.
   • Cost effective drug therapy.
   • Prescription for non-formulary products.
2. Carries out, as appropriate, Medication Use Evaluation Program initiatives through active prescriber intervention and education.
3. Serves on intra- and interdepartmental committees, task forces, and teams as required. 

Provides Educational Services

University of Iowa Health Care is a teaching institution; therefore, the clinical pharmacist is responsible for the education of students, fellow staff, other healthcare providers, and patients about drugs and their appropriate use.  The clinical pharmacist shall serve as a role model for staff and students.  The educational process crosses professional boundaries, as the clinical pharmacist interacts with and serves as an informational resource for other members of the health care team.  The clinical pharmacist takes great care to instruct all patients about the need for and appropriate use of prescribed medications. Examples of educational services may include:

1. Serving as preceptor for pharmacy students and pharmacy residents. 
2. Presenting in-service educational programs to staff nurses, physicians, and other colleagues on the healthcare team.
3. Conducting patient education classes about the proper use of medications.
4. Serving as mentor and role model for other pharmacist practitioners within the department, particularly those who provide ambulatory care services. 

Facilitates Transitions of Care

The ambulatory care clinical pharmacist participates in the facilitation of patient transfer from the inpatient to the outpatient setting. Part of the responsibility involves the bedside delivery of discharge medications directly to the patient to provide appropriate medication education at the point of care to expedite the discharge process. 

Participates in Research

The ambulatory care clinical pharmacist may participate in research activities, including providing support for Investigational Drug Service prescriptions and orders.  This research may take many forms, including developmental, evaluative, and/or clinical research.  It may be intradepartmental or interdisciplinary in format.  The presentation and/or publication of research findings are encouraged. 

Complete and maintain compliance with all competencies and educational requirements.