General Summary

Under limited supervision, provides a high level of direct patient care pharmacy services for an assigned, specialized patient population to assure adequate patient care according to professional standards and practices. Advises/consults with patients and their families and the medical and nursing staff. Participates in research and drug use and outcome management programs within specialty area; responsible for publishing data or giving presentations at local, regional or national meetings; instructs and trains pharmacy residents and students; assists in overseeing and directing the clinical services provided by pharmacists. Acts as a mentor to clinical pharmacists.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

Clinical Pharmacy Services

• Participates in direct patient care with a medical or surgical team.
• Assists with therapeutic decisions such as drug product selection, drug dosing and therapeutic drug monitoring.
• Develops patient care plans in concert with the medical team.
• Recommends therapy or alternative approaches based on interpretation of relevant medical literature and clinical experience.
• Makes verbal or written recommendations in a clear, succinct and appropriate manner.
• Considers age, weight and organ function (e.g. renal, hepatic) when evaluating patients and patient's therapies when making recommendations.
• Interviews patients and conducts physical assessments to determine medical history, previous medication condition and response to therapy.
• Interprets laboratory and other patient-specific data to develop treatment plans and to monitor response to therapy.
• Applies pharmacokinetic principles in order to achieve efficacious, safe and economical pharmacotherapeutic regimens.
• Responds to therapeutic queries posed by physicians and other healthcare providers.
• Identifies and corrects drug-related problems such as complications resulting from drug therapy (ineffective therapy, allergic reactions and adverse drug reactions).
• Establishes procedures for detecting significant drug-drug, drug-laboratory and drug-food interactions. Makes recommendations to avoid such interactions.
• Performs basic cardiac life support and participates in drug therapy management during medical emergencies.
• Ensures a continuum of care by cooperating with other health professionals and outside health organizations.
• Counsels patients and/or caregiver as to the proper administration, potential adverse reactions, storage of medications, etc.

Drug Use, Outcome and Formulary Management

• Ensures and enforces compliance with established clinical protocols and guidelines with the multidisciplinary care providers.
• Works with the Coordinator of Drug Use and Outcome Management in identifying and establishing programs that improve drug therapy outcomes (efficacy, safety, cost-effectiveness) and overall quality of patient care.
• Works with the Coordinator of Drug Use and Outcome Management and Formulary Management in implementing and monitoring drug use management programs.
• Participates in the Medication Use Evaluation Program by designing drug use criteria, collecting patient information, providing accurate analysis and reporting data.
• Participates with the Coordinator of Drug Use and Outcome Management in clinical pathway development and other related managed care initiatives such as disease management programs.
• Participates in the formulary management process including development of drug monographs, treatment protocols, drug use policy, algorithms and guidelines for use with the Coordinator of Drug Use and Outcome Management and Formulary Management and within the purview of the P&T Committee.
• Documents pharmaceutical care interventions conscientiously as part of the departmental documentation program.