Inpatient Pharmacy Services Please Help!

[Fxguy1]

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I am having some trouble working at the hospital where I am currently employed. Most of the staff there are VERY resistant to change and technology. We have 14 pharmacists on staff including 2 clinical pharmacists (One full, one part-time) the director, two full time night pharmacists, 3 full time pharmacists and 5 part time pharmacists. Aside from the clinical pharmacists rounding in CCU and Vanomycin / Aminoglyoside monitoring, we provide very little in the way of services. I found out that our sister hospital has only 8 pharmacists on staff and they have a pharmacist full time in the ER, they staff daily in their cancer center 6-7 hours, and they round on every floor with their pharmacists splitting their time between staff and clinical responsibilities.

So I am seeking out the advice from my fellow inpatient pharmacists.

1. What advice would you give to starting pharmacy services?

2. What pharmacy services do you provide?

3. What pharmacy services would you like to provide, but dont currently?

The director is trying to drag his feet and stop anything new from being done, including bar coding! He is constantly trying to do the least amount of work and it is pervasive throughout the department. So I figure he can't stop me from providing clinical services on my day off by volunteering. I have offered to volunteer 4 hours a week to start clinical services in the ER by doing admitting med histories and discharge patient counseling. They were so suprised by this that the head of volunteer services emailed me saying it is unprecedented and they dont have a policy to deal with it. She said give her a week to figure things out. So as I wait, I am thinking of what services I can start providing as a volunteer pharmacist to demonstrated to the other department heads how valuable the pharmacist can be. (By the way, I feel that much of the rest of the hospital would welcome more pharmacy involvement and that it is our director that is the problem, the department seems too scared to do anything. I mean the residents constantly write "per pharmacy protocol" and we still have to call them if we figure out the dose and frequency! )

Please help!

 

[Its Z]

I am having some trouble working at the hospital where I am currently employed. Most of the staff there are VERY resistant to change and technology. We have 14 pharmacists on staff including 2 clinical pharmacists (One full, one part-time) the director, two full time night pharmacists, 3 full time pharmacists and 5 part time pharmacists. Aside from the clinical pharmacists rounding in CCU and Vanomycin / Aminoglyoside monitoring, we provide very little in the way of services. I found out that our sister hospital has only 8 pharmacists on staff and they have a pharmacist full time in the ER, they staff daily in their cancer center 6-7 hours, and they round on every floor with their pharmacists splitting their time between staff and clinical responsibilities.

So I am seeking out the advice from my fellow inpatient pharmacists.

1. What advice would you give to starting pharmacy services?

2. What pharmacy services do you provide?

3. What pharmacy services would you like to provide, but dont currently?

The director is trying to drag his feet and stop anything new from being done, including bar coding! He is constantly trying to do the least amount of work and it is pervasive throughout the department. So I figure he can't stop me from providing clinical services on my day off by volunteering. I have offered to volunteer 4 hours a week to start clinical services in the ER by doing admitting med histories and discharge patient counseling. They were so suprised by this that the head of volunteer services emailed me saying it is unprecedented and they dont have a policy to deal with it. She said give her a week to figure things out. So as I wait, I am thinking of what services I can start providing as a volunteer pharmacist to demonstrated to the other department heads how valuable the pharmacist can be. (By the way, I feel that much of the rest of the hospital would welcome more pharmacy involvement and that it is our director that is the problem, the department seems too scared to do anything. I mean the residents constantly write "per pharmacy protocol" and we still have to call them if we figure out the dose and frequency! )

Please help!

PM me if you want some input.

 

[Fxguy1]

pm'd

 

[Its Z]

FXguy,

I commend you for believing there's more to health system pharmacy practice than getting the meds to the patient. You belong with the 2 percent of pharmacists who shake and rattle to improve our profession.

That being said, "everyone wants a job but nobody wants to work." Your DOP is one of those who goes to work to collect a pay check. And he will not change until forced to do so. Unfortunately, this attitude has disseminated throughout the pharmacy and I hope you do not get infected with the dreaded "everyone wants a job but nobody wants to work" syndrome.

There are several different ways to bring forth a change.

• Hospital Administration demands a change after a consultant report.
• You and your colleagues provide a protocol and get it passed through necessary committees with or without your DOP.
• Your DOP drops dead and you become the next DOP.
• Bring in a pharmacy management company.

Quality pharmacy service improves patient care and lowers cost. Knowing how to improve quality is a challenge. Ability to quantify hard dollar cost savings through pharmacy quality improvement is even more difficulty for most.

The 2nd topic is something that's not taught in pharmacy school or even in PGY2 pharmacy management programs. And pharmacy management consultants charge a premium for this sort of service.

 

[Fxguy1]

Well I heard back from volunteer services and was told I cannot volunteer because there are rules and regulations that prevent an employee from working in a volunteer capacity in their department. So I asked if I wasn't working here then this would not be an issue? She replied that then it would be possible, but I would still need the approval of the pharmacy director!
I have never seen a hospital where the pharmacy director had so much say in what went on. Oh and did I mention his wife works as a staff pharmacist for us part time? Talk about a violation in policy!

Perhaps I should just work up a business plan of my own to present to hospital administration showing ways I could save them time and money. I just wrote on my blog :
http://mypharmacylife.wordpress.com/2011/04/11/under-new-management-someday/
about how managers have no idea how to ask for budget increases because they don't demonstrate what their plans for the money are. I think my pharmacy director could easily get more money if he approached administration with a plan showing exactly what services we could provide, the cost of those services, and the return on investment expected in the form of increased patient safety, decreased readmission, and reduced labor hours spent clarifying problems created by not having these services.

Fxguy1

 

[Its Z]

you should come work for us.

 

[Fxguy1]

And where are we located? LOL! I am beginning to hate finding my path in life! At first I didnt want to be a pharmacist. I wanted to be the only pharmacist to graduate pharmacy school and not become a pharmacist. I wanted to be a filmmaker. Then as graduation approached I figured I would work retail, make money and go home. Then I could use my money to finance my own films.
Then I found out that work is hard, I come home too tired to do anything and my wife wanted a house and kids. Also found out in retail life sucked, no break, expected to be a robot 12 hours a day. Bought a house, still working on kids. At the end of my two year contract I left to work in the hospital. This hospital has changed my mind about being a pharmacist. I truely enjoy it now, and want to do more. I want to do things like we did while I was on those dreaded rotations and cant! So now I know I like hospital / clinical and that I enjoy working on projects and computer / information systems instead of working on an order que. But seems that my current employer does not want to create a position for me because that doesnt mesh with his ideas of how the pharmacy should be, which are the same way it was in 1970! Everyday I hear, I hate these computers, they never work right. Well if you had someone , oh I dont know say ME! working to maintain them and be there to help, then perhaps it would be better.

Sorry for the rant!

Fxguy1

 

[Its Z]

What kind of equipment are you using for "film?"

Old Canon FD prime lenses (good ones) are getting harder to find...

 

[Fxguy1]

I was really trying to get my hands on a Panasonic HVX. In the 3rd year of pharmacy school I even took a precision machine tooling class at the local Junior College where I machined a 12 foot camera crane, a skateboard dolly, and a steady-cam complete with vest. I had started writting a couple of screenplays. I find my ADD gets in the way sometimes, other times its lack of know how / my introverted nature. Many of my ideas I've seen someone else take and make a reality. I think I would make a great entrepreneur , a Richard Branson of sorts, starting businesses and then moving on to start something new. When the iPhone first came out, I wanted to create an app for $0.99 that managed your prescriptions and you could click refill right from your phone and go pick it up at the local pharmacy. Or an app where you could leave digital graffitti for others to look at (imagine virtual "tags" where you could leave grafitti on the Mona Lisa for example) or an app where local writers could publish their stories and in order to read them, you would have to be in the location where if took place (made possible by GPS tags that most smart phones use nowadays) my list goes on and on.

For healthcare why not have a patient Bed that will transmit the weight directly to the patient chart associated with that bed? Or for that matter the thermometer or blood pressure cuff? Why do we have all these wonderful digital machines to measure patient vitals but they don't talk to each other or the chart? Please, don't get me started.....

Fxguy1