Clinical Pharmacy Specialist Transitions of Care

Primary Function

The TOC pharmacy specialist works with the Care Managers, Physician Advisors and providers to enhance transition of care, an activity that includes appropriate inpatient medication regimens, medication reconciliation at discharge, patient medication counseling, post-discharge phone call and communication of medication changes to appropriate medical providers. The TOC pharmacy specialist serves as a patient advocate, ensuring that quality care is provided.

Responsibilities

Coordinates a transitions of care medication plan for high risk patients transitioning from hospital to home. Review and reconcile all medications upon discharge to assess for potential duplicate therapy, inappropriate dosing, or missing medication orders/prescriptions.

Conducts post-discharge patient follow-up phone calls to ensure patient understanding of medical discharge plan and provide additional medication education, as needed.

Reviews medication orders and monitor laboratory parameters and adjust medication to ensure optimal therapy in collaboration with providers. Communicate directly with prescribers to resolve medication related issues. Coordinates the dispensing of discharge medications, if necessary.

Educates and counsels patients on medications and explains in detail any and all changes to their regimen. Addresses and resolves potential barriers to patient understanding.

Addresses and resolves potential barriers to medication access prior to discharge, as appropriate.

Attends multi-disciplinary rounds to determine patient’s disposition when needed. Educates physician and clinical staff on TOC related topics.

Participation in departmental transitions of care program enhancement and expansion.

Serves as a pharmacy representative on the hospital readmissions committee.

Precepting Pharmacy Students/Residents

In addition to the above responsibilities, the TOC pharmacy specialist participates in the PGY1 pharmacy residency program as a preceptor for at least one elective Ambulatory Care/Transitions of Care rotation for each resident and may precept additional elective rotations and/or the major project. In addition, the TOC specialist pharmacist may participate in student preceptor activities. The pharmacist will model, coach and facilitate the resident’s learning to be able to perform the duties of a TOC pharmacy specialist.

Job Qualifications and Specifications

Doctor of Pharmacy (PharmD) degree with PGY-1 post-graduate residency training or equivalent experience (2-5 years of experience in Ambulatory and/or Transitional Care Pharmacy and inpatient care) or PGY-2 in Ambulatory Care. Current RI Pharmacist license is required. Board Certification in Pharmacotherapy (or Board-eligible) is preferred but not required.

Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

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