Clinical Pharmacy Specialist - Pediatric Clinics Pharmacist

This ambulatory pharmacist will work with other pharmacists in the Pediatric Specialty Clinics (Dermatology, Gastroenterology (GI), Rheumatology, Allergy & Immunology, Neurology, Endocrinology, and Pulmonary), Pediatric Hematology/Oncology clinic, and other Pediatric Specialties to provide pharmacy services to patients. Common disease states this pharmacist could help manage include infantile hemangiomas, Inflammatory Bowel Disease, Juvenile Idiopathic Arthritis, severe asthma, cystic fibrosis, epilepsy, growth hormone deficiency, bone marrow transplant, and leukemia. The pharmacist works collaboratively with the multidisciplinary healthcare team to provide care for patients. They will answer clinical questions about medications, provide education on new therapies and medication devices, coordinate dispensing, as well as medication monitoring and management for patients receiving specialty medications through UI Health Care Specialty Pharmacy Services. Additionally, they may provide clinical guidance on treatment protocols, assist with verifying clinic orders, mange adverse effects of therapy regimens, and assist with clinical management of medications in clinical trials. The pharmacist also serves as a role-model/practitioner-educator for Doctor of Pharmacy students and pharmacy residents and carries out clinical practice responsibilities for the Department of Pharmaceutical Care.

Patient Care - Participate in the provision of pharmaceutical care in select clinics

• Be present in clinics when patients are scheduled to see the pharmacist and when clinical pharmacy services are required
• Complete a comprehensive patient assessment including medication history, pertinent physical assessment, and assessment of relevant laboratory values, patient interview, and an evaluation of past medical history for appropriate patients
• Work with physicians, nurses, pharmacists, and other health care providers as a member of the multi-disciplinary team
• Provide disease state management and medication therapy management services through the use of collaborative practice agreements and protocols
• Provide in-depth patient medication assessment and education
• Provide follow-up of therapeutic recommendations through telephone calls and return clinic appointments as appropriate
• Identify, evaluate, and prevent adverse drug events through appropriate interventions
• Communicate therapeutic recommendations to the health care provider
• Document relevant clinical information in electronic medical record
• Coordinate medication-planning activities including facilitation of prescription writing, patient education, coordination with family members or home health care providers, etc.
• Collaboratively address financial issues to ensure receipt of needed medications
• Serve as liaison for ambulatory pharmacy staff regarding patient medication therapy
• Coordinate therapeutic decision-making when there is a paucity of literature or experience for reference
• Serve as the primary reference source on new drug therapy advances in the specialized area of practice
• Provide staffing support to Specialty Pharmacy Services when needed
• Complete patient follow-up calls to address side-effects/adherence
• Evaluate patient-specific medication regimens to ensure the appropriateness of the following:
• Indication
• Correct dose
• Route of administration
• Drug-drug, drug-food, drug-lab, or drug-disease state interactions
• Efficacy of therapy
• Adherence to therapy
• Dose adjustments for organ dysfunction
• Adverse drug reactions
• Potential drug misuse or abuse
• Use of the most cost-effective therapy
• Availability of medications on the UI Health Care Formulary (if applicable)

Documents All Patient Care Activities Performed

The active participation of the pharmacist as a member of the healthcare team requires efficient communication of activities to all those who participate in the care of patients.  Provision of pharmacy-related services requires the sharing of information with other members of the team through documentation within the patient medical record and other on-line reporting systems as well as through intradepartmental channels which provide adequate documentation of such services to departmental and hospital administrative personnel.

• Documents all patient drug allergies and patient-specific height and weight information, as applicable.
• Documents medication histories.
• Documents the provision of medication counseling to patients.
• Documents interventions with prescribers and other healthcare providers.
• Documents all interactions with patients
• Documents applicable drug dosing recommendations made to prescribers.
• Documents applicable Drug Use Evaluation Program activities.
• Documents steps taken to identify, evaluate, or avoid adverse drug reactions.
• Medication errors into standard reporting system.
• Design, implement, and coordinate development of the clinical components of the pharmacy or hospital wide information systems.
• Develop and coordinate policies, procedures, and clinical reference documents relevant to the clinical applications of new therapies.

Facilitates Operational Initiatives Which Lead to Enhanced Patient Care Services

The pharmacist must assume the role of patient advocate for all issues associated with drug therapy.  The pharmacist must position him/herself so 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.

Follows-up on any medication system problems, such as:

• Unclear or inappropriate prescription orders
• Drug therapy which is not most cost effective
• Prescription order for non-formulary products
• Missing or untimely medication doses
• Carries out, as appropriate, Medication Use Evaluation Program initiatives through active prescriber intervention and education.
• Develop or contribute to the development of protocols related to appropriate prescribing, dispensing and monitoring of medications
• Provide a leadership role in department or interdisciplinary hospital committees involved with drug therapy issues
• Complete clinically oriented departmental goals
• Manage and analyze events related to medication errors – including participation in informal multi-disciplinary sentinel event review teams
• Interview and evaluate prospective professional pharmacy practitioners
• Adhere to all department policies and procedures
• Contribute to the department budgetary process by reviewing, designing, implementing, and monitoring budget initiatives that address hospital wide or unit specific issues
• Participate with the implementation and monitoring of new programs developed either by the Department or through another means (e.g., P&T Committee)
• Participate in the rotation with other specialists to support 24-hour, 7-day/week on-call coverage to ambulatory care patients for drug therapy issue problem solving. This occurs approximately 1-2 weeks per year and historically has low usage.
• Provide a leadership role in university committees involved with drug therapy
• Develop and conduct measurement activities that demonstrate Specialty Pharmacy Service value, including adherence and outcome measures
• Perform quality assurance monitoring of services provided by the UI Health Care Specialty Pharmacy Services
• Develop educational programs to certify the clinical competence of pharmacists and improve the technician understanding of medical conditions being treated

Provide Educational Services

An important responsibility of the pharmacist is the education of students, fellow staff, other healthcare providers, and patients about drugs and their appropriate use.  New and future pharmacy practitioners are continually exposed to the day-to-day activities of the practicing pharmacist; thus, the pharmacist must serve as a role model for these staff and students.  The educational process must also transcend to other disciplines, as the pharmacist interacts with and serves as an information resource for other members of the health care team.  Lastly, the pharmacist takes great care to instruct all patients about the need for and appropriate use of prescribed medications.

• Serves as preceptor for pharmacy students and pharmacy residents on clinical rotations sponsored by the UI Health Care Department of Pharmaceutical Care.
• Presents in-service educational programs to staff nurses, physicians, and other colleagues on the healthcare team.
• Presents at and/or participates in other educational programs sponsored by the Department of Pharmaceutical Care, the College of Pharmacy, other UI Health Care or UI departments, and state and national organizations.
• Conducts educational classes for pharmacy students and pharmacy residents as appropriate.
• Conducts patient education classes about the proper use of medications as appropriate.
• Serves as mentor and role model for other pharmacist practitioners within the department, particularly those who provide ambulatory care services.

Participates in Research

The ambulatory care pharmacist participates in research activities as appropriate, 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.

Other

• Consistently demonstrate the WECARE values and Service Excellence culture of UI Health Care
• Complete and maintain compliance with all competencies and educational requirements