clinical pharmacy services - weber state university

Clinical Pharmacy Services

An Introduction to the World of Pharmacy

The World of Pharmacy

2© 2006 Intermountain Healthcare

HospitalsMedical Group

Central Office

Health PlansHomecare

Most Healthcare

systems have a similar

structure


Intermountain Medical Group

Retail

Clinics

20 Retail Pharmacies

Primary Care&

Specialty Care

Community Pharmacy

Patient training for diseases such as:

DiabetesAsthmaHypertension

Consult with:PhysiciansNursesPhysician Assistant'sMedical AssistantsPhysical Therapists, etc.


http://images.google.com/imgres?imgurl=http://www.computerized-screening.com/userimages/Retail%2520Pharmacy.jpg&imgrefurl=http://www.computerized-screening.com/main.php%3Fclick1%3Dsales%26click2%3Dpharm_retail&h=185&w=280&sz=27&tbnid=9GqsmaEeBZT_eM:&tbnh=72&tbnw=109&hl=en&start=2&prev=/images%3Fq%3Dretail%2Bpharmacy%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.zebra.com/id/zebra/na/en/index/industry_solutions/industries/retail/retail_pharmacies.194.159.Image.gif&imgrefurl=http://www.zebra.com/id/zebra/na/en/index/industry_solutions/industries/retail/retail_pharmacies.html&h=159&w=194&sz=37&tbnid=M_qp46p6OQQKZM:&tbnh=80&tbnw=98&hl=en&start=39&prev=/images%3Fq%3Dretail%2Bpharmacy%26start%3D20%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive%26sa%3DN

http://images.google.com/imgres?imgurl=http://www.msnrecruiters.com/images/pharmacist2.jpg&imgrefurl=http://www.msnrecruiters.com/&h=225&w=180&sz=9&tbnid=OPsazS_kY9ttCM:&tbnh=102&tbnw=81&hl=en&start=69&prev=/images%3Fq%3Dretail%2Bpharmacy%26start%3D60%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive%26sa%3DN

Community Pharmacy

Detailed & Private Patient Medication Counseling Personal patient help with Medicare D & insurance 3rd parties.Physician & Health Plan formulary issues.Help Prevent Adverse Drug EventsProfessional & Clinical Practice SettingProfessional Experience Programs with Schools of Pharmacy


http://images.google.com/imgres?imgurl=http://www.covitechnologies.com/user_files/images/verticals/pharmacy.gif&imgrefurl=http://www.covitechnologies.com/communities/retail&h=150&w=150&sz=19&tbnid=KAkJZkapAPNkNM:&tbnh=90&tbnw=90&hl=en&start=137&prev=/images%3Fq%3Dretail%2Bpharmacy%26start%3D120%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive%26sa%3DN

http://images.google.com/imgres?imgurl=http://www.dac.neu.edu/coop.pharmacy/7retail2.jpg&imgrefurl=http://www.dac.neu.edu/coop.pharmacy/rxsites2.html&h=216&w=265&sz=26&tbnid=BFbI46ZBj9XmIM:&tbnh=88&tbnw=108&hl=en&start=208&prev=/images%3Fq%3Dretail%2Bpharmacy%26start%3D200%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive%26sa%3DN

Community Pharmacy in an Integrated System


Part of integrated health system = special benefitsIncreased access to patient informationEasier to monitor patientsHelp transition patients from hospital to homeFor example, Liver transplant patients who have very complex medication regimens

Help ensure patients are on optimal therapyFor example, all patients post heart attack are on the appropriate medications that

are know to improve their outcomesClose to prescribers (or pharmacist may be prescribing under approved protocols)

Develop excellent relationshipsEasier access for questions and recommendations

Ambulatory Pharmacy


Pharmacist or Physician runPhysical AssessmentPharmacist/Physician agreements for medication ordersOrder lab testsPatient education

Some Pharmacists integrate ambulatory clinics with retailDisease state certificationsBilling for services


Homecare

Infusion Services

Hospice


Health Plans

Health Maintenance

Formulary

Health Plan Administration

Disease State Management

Health Plans

PRESENTATION NAME HERE 10© 2006 Intermountain Healthcare

• A typical day….• P&T Presentation

Preparation• Team Based Guideline

Development• Physician Detailing• Drug Expense Trending• Prior Authorization

Review

Brieana Buckley, PharmD. teaching technicians about a new pharmacy benefit.


Hospitals

22 HospitalsPark City

Riverton

IMC

Urban RuralUNRUCRUSRSWR

PCMC

Urban North Region

Urban Central Region

Urban South Region

Primary Children’s Medical Center

20 – 40 beds

Critical Access

South West Region

Hospital Pharmacy


Distribution of medicationsHigh level of technology

RobotsAutomatic medication cabinetsMostly technicians under pharmacist supervision

Clinical Patient careEducationDrug information

http://images.google.com/imgres?imgurl=http://www.mercydesmoines.org/images/pharmacy/robot.jpg&imgrefurl=http://www.mercydesmoines.org/schoolsProg/leadingEdgeTechnology.asp&h=317&w=324&sz=41&tbnid=oSVgDhAA_nwsVM:&tbnh=111&tbnw=114&hl=en&start=2&prev=/images%3Fq%3Dmckesson%2Brobot%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.sunrisehospital.com/cpm/equip1.jpg&imgrefurl=http://www.sunrisehospital.com/CustomPage.asp%3FguidCustomContentID%3D%257B0AEF8CD2-9FB5-11D4-81F3-00508B1249D5%257D&h=200&w=200&sz=38&tbnid=s_4lgRVkHWidUM:&tbnh=99&tbnw=99&hl=en&start=9&prev=/images%3Fq%3Dmckesson%2Brobot%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.zionshope.com/ZHclassifieds/medical_images/Pharmacy/Dispensers/ROBOT-RX-8sm.jpg&imgrefurl=http://www.zionshope.com/ZHclassifieds/index.php%3Fsetlang%3Drus&h=132&w=175&sz=10&tbnid=AzTRiQs4x8wdaM:&tbnh=71&tbnw=95&hl=en&start=13&prev=/images%3Fq%3Dmckesson%2Brobot%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.nanwhite.com/portfolio/daed/images/acudose.jpg&imgrefurl=http://www.nanwhite.com/portfolio/daed/projects.html&h=168&w=110&sz=8&tbnid=iR-d2ir4wWn8dM:&tbnh=93&tbnw=60&hl=en&start=10&prev=/images%3Fq%3Dmckesson%2Bacudose%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.hopkinspharmacy.org/customers/Pictures/Pharmacy_06.jpg&imgrefurl=http://www.hopkinspharmacy.org/customers/PictureAlbum.html&h=889&w=1347&sz=1139&tbnid=faObPgYMkvVxZM:&tbnh=98&tbnw=150&hl=en&start=7&prev=/images%3Fq%3Dhospital%2Bpharmacy%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.pharmacy.manchester.ac.uk/images/Hospital.jpg&imgrefurl=http://www.pharmacy.manchester.ac.uk/Career/HospitalPharmacy&h=200&w=250&sz=42&tbnid=4cSLytrSTMP_HM:&tbnh=84&tbnw=106&hl=en&start=10&prev=/images%3Fq%3Dhospital%2Bpharmacy%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive

http://images.google.com/imgres?imgurl=http://www.fotosearch.com/comp/corbis/DGT198/RLM0059.jpg&imgrefurl=http://www.fotosearch.com/DGT198/rlm0059/&h=200&w=300&sz=23&tbnid=QfaifsIEBTQnuM:&tbnh=74&tbnw=111&hl=en&start=37&prev=/images%3Fq%3Dhospital%2Bpharmacy%26start%3D20%26svnum%3D10%26hl%3Den%26lr%3D%26safe%3Dactive%26sa%3DN

Adult Critical Care


Monitor PatientsLabs & Drug levelsPhysical condition (kidney, liver..)

Protocols & Medication ordersSafety issuesMedication effectsMeeting patient outcome goalsRounding with medical teamsPreventing/treating ADEsAssisting with codesDrug InformationResearchTroubleshootingPatient

Rounds

DiscussingPatientissue with RN

Cardiovascular Pharmacy


Internal Medicine


Pediatric Pharmacy


Neonatal Pharmacy


Education


PatientsMedical studentsPharmacy studentsPhysiciansPharmacy TechniciansNurse PractitionersRespiratory TherapistsMany others!

Physician teaches students, residents, & Pharmacists about Acute Respiratory Disease


Central Office

Administration

System-wide Formulary & Purchasing

Clinical Support

Operational Support

Information System Development & Support

Pharmacy Management


Medication safetyClinical ProgramsFormularyEducationNew initiativesMuch more….!

Data Management


• Data reports• Clinical reports• Research• Pharmacy & Therapeutics Committee support• Automation Strategy & use

RobotsAutomatic dispensing cabinets

• Drug Use EvaluationVance Loertscher, RPhData Manager

System Development & Implementation


• Computer system design• Clinical decision support tools• Database design• Database management• System testing• Education & training• Medication order sets• Patient care protocols• Clinical Patient Care tools

Opportunities


Shadowing - observe

Internships - work

Clerkships - rotation

Residency – post graduate

Certification – post graduate

All provide excellent opportunities to experience the

different avenues of pharmacy

Residency


Kelly Terrill, Pharmacy Director

Back to the Future


Lifelong LearningResidency TrainingBoard Certification

PharmacotherapyNuclear PharmacyNutrition SupportOncologyPsychiatryOthers….

Getting Ready….


There’s a whole world of different options for Pharmacy ProfessionalsExploreShadowNetwork

Many Exciting Opportunities…….Be ProactiveAsk Questions!Let us know how we can help youOpportunities to get involved with the Utah Society of Health-System Pharmacists - USHP (no charge to students)

clinical pharmacy services - weber state university

Documents