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Clinical Pharmacist

2 months ago

Boston, United States Brigham and Women's Hospital Full time
Description

Hybrid - Primary Care

Shift: 40hr Day position

Responsible for the optimization of drug therapy by identification, resolution, and prevention of drug related problems and improving therapeutic outcomes.

Responsible for providing patient care according to the laws and regulations governing pharmacists and the practice of pharmacy by the appropriate state and federal agencies. When assigned to particular pharmacy service teams, may be responsible for prescribing medications under specific collaborative drug therapy management agreements (CDTM).

Works relatively independently, and within the limits of established pharmacy/ambulatory care practice site's policies and procedures, as a member of the patient care team. Directs and coordinates the activities of a pharmacy service area. Supervises all support personnel during an assigned shift, operating within the limits of pharmacy policy and procedures, and the regulations of the Board of Registration Pharmacy.

Principal Duties and Responsibilities

1. Leadership

a. Provide direction and guidance to pharmacist and ancillary support including technician staff in following policy and procedure, taking accountability and ownership of job responsibilities, and promoting professional behavior and attitudes.

b. Provide feedback to the pharmacy managers/practice managers/medical directors for the interim and annual performance appraisal of other pharmacists, pharmacy technicians, pharmacy interns, physicians, medical residents, medical interns and medical assistants when appropriate.

c. Participates in resolving personnel management issues, when requested by the management staff.

2. Direct and Indirect Patient Care Services

a. Directs and coordinates the delivery of pharmacy services on the assigned shift, without direct supervision.

b. Supervise and verify the accuracy of all work completed by support personnel assigned to the area.

c. Responsible for the interpretation and implementation of all departmental policies and procedures on the assigned shift.

d. Prepare, compound, and dispense medications to patients according to the laws and regulations of the Board of Registration in Pharmacy, Department of Public Health Food and Drug Administration, and other regulatory agencies when appropriate.

e. Attend and participate in daily medical and multi-disciplinary rounds and participate in specialty rounds as needed and as time allows and collaborate with other healthcare providers when staffing non-rounding services.

f. Interprets, clarifies and evaluates all medication and related laboratory orders for completeness and appropriateness. Communicates with physicians and nurses on medication order discrepancies, possible drug interactions or stability problems. Assures that all patient medication profiles contain the required medication information and clinical data necessary to monitor the patient's pharmacotherapy.

g. Provides prospective evaluation and monitoring of patient drug therapy. Recommend appropriate medication doses and adjustments as indicated by patient conditions. Identifies, documents, resolves, and works to prevent drug therapy related problems.

h. Participates in pharmacokinetic dose monitoring of selected medications and recommends dose adjustments and laboratory monitoring as required meeting patient needs in accordance with approved guidelines and protocols.

i. Recommend drug related labs and interpret results when appropriate.

j. Provide drug information and consultation to patients, physicians, nurses and other health care professionals regarding appropriate drug therapy, including drug interactions, side effects, incompatibilities, allergies, medication order/prescription discrepancies, drug stability problems, and drug administration.

k. Identify, document, resolve, monitor, and prevent drug therapy related problems, including contraindications, duplications of therapy, and drug interactions.

l. Monitors drug therapy to prevent contraindications, duplicate therapy, drug interactions and allergic reactions. Reports and documents all adverse drug reactions to pharmacy leadership and appropriate hospital committees.

m. Perform all other responsibilities as assigned in a complete and timely fashion.

3. Quality and Safety

a. Maintain expertise in the departmental policies and procedures.

b. Follow all policies, procedures, laws, and regulations set forth by the Board of Pharmacy and all other applicable regulatory agencies.

c. Ensure compliance with target drug programs, formulary management, medication management initiatives, and adverse drug event monitoring programs.

d. Document and report clinical interventions, medication errors, adverse drug events.

e. Actively participates in the development and performance of drug use evaluations and other drug therapy monitoring initiatives.

f. Maintains skill and competency level to comply with departmental and hospital quality assurance standards.

g. Participates in department quality improvement efforts

4. Education, Training, and Professional Development

a. Attend and participate in departmental and change of shift staff meetings, M&M rounds, staff development and continuing education activities.

b. Participate in departmental quality improvement committees, programs, and student/resident presentations.

c. Attend, participate in, and conduct continuing education programs and conferences to keep current with developments in the profession.

d. Maintain pharmaceutical care expertise through membership and participation in professional organizations, continuing education, and contributing to peer-reviewed literature.

e. Attend and participate in journal club review, in-services, and case studies for afternoon pharmacist meetings.

f. Assist and contribute to the orientation and training of new personnel as assigned.

g. Serves as a preceptor for pharmacy interns and externs with the Massachusetts Board of Registration in Pharmacy in accordance with 247 CMR 8.01(16) where appropriate.

h. Serves as a preceptor for pharmacist resident and fellows where appropriate

i. Participates in the training of medical, nursing and allied health professionals.

5. Use of Technology and Automation

a. Utilize area-specific technology, including, but not limited to, robotics, automation, software, equipment, and information systems.

b. Troubleshoot and mitigate short-term issues related to the area specific technology.

Additional Principal Duties and Responsibilities

  1. Reviews and monitors patient medication regimens for appropriateness based on current clinical and institutional guidelines as well as patient-specific criteria.
  2. Identifies, documents, resolves, and works to prevent drug therapy related problems Documentation includes clinical interventions, adverse drug events and drug therapy profile reviews.
  3. Under the supervising of a credentialed pharmacist - initiates, modifies, and/or discontinues medications associated with disease states for which the pharmacist is credentialed to prescribe under a CDTM agreement and for which a supervising physician has referred the patient for management.
  4. Attends and participates in additional teaching, research, and quality efforts within the department as well as in collaboration with other departments within MGB. This includes but is not limited to journal club review, in-services, and M&M rounds.

5. Evaluate ambulatory prescriptions and appropriately prescribe and send prescriptions through ambulatory care system when appropriate.

  1. Attends, participates in, and conducts continuing education programs and conferences to keep current with developments in the profession and to maintain license.
  2. Works in collaboration with pharmacy and medical director leadership to develop and maintain anticoagulation and other pertinent disease state management policies and procedures.
  3. Works in collaboration with pharmacy and hospital leadership to develop and maintain informatics builds when appropriate.
  4. Assists and contributes to the orientation and training of new personnel as assigned.
  5. Serves as a preceptor for clinical pharmacy internship and externship students and/or residents.
  6. Provides information and consultation to physicians, nurses, and other healthcare professionals, regarding appropriate drug therapy. Gives advice on drug interactions, side effects, and allergies.
  7. Supervises and verifies the accuracy of all work completed by supportive personnel assigned to the area. This includes providing feedback on the annual performance appraisal for support personnel, including Pharmacy students.
  8. Maintains skill and competency level to comply with departmental and hospital Quality Assurance standards.

PRINCIPLE DUTIES AND RESPONSIBILITIES SPECIFIC TO CDTM - Note: Staff who are required to acquire/achieve appropriate credentialing and licensures for collaborative drug therapy management, will identify themselves as having an advanced practice designation.

1. The pharmacist shall hold a current unrestricted license in good standing to practice pharmacy in the Commonwealth and currently be engaged in pharmacy practice in the Commonwealth.

2. Must have Massachusetts Controlled Substance Registration license, National Provider Index number, and a Drug Enforcement Administration Registration number, if applicable.

3. The pharmacist shall wear a nametag, which identifies him/her as a pharmacist.

4. The pharmacist shall have completed 5 years' experience as a licensed pharmacist or have satisfied one of the requirements in 247 CMR 16.02(1)(c)

a. Have earned a Doctor of Pharmacy degree and have entered into a collaborative practice agreement on or before 2017; or

b. Have completed such other education or residency criteria that the MA Board of Pharmacy determines to be the equivalent of five year's experience as a licensed pharmacist.

5. The pharmacist shall devote a portion of practice to the defined drug therapy area that the pharmacist shall co-manage.

6. The pharmacist shall complete, in each year of the term of the protocol, at least 5 contact hours or 0.5 continuing education units of Board-approved continuing education that address areas of practice generally related to the particular collaborative practice protocol.

7. The pharmacist must notify the Board of Registration of Pharmacists of change of employment, supervising physician or departure from the state within 30 days. Whenever an authorized pharmacist participating in CDTM is disciplined by the Board, whether by agreement or Board order, or otherwise subject to any practice restrictions, the authorized pharmacist must provide written notification of such discipline or practice restriction to each supervising physician.

8. A supervising physician or physician designee may permit a pharmacist to approach patients of all ages and with all types of conditions, to perform the following tasks pursuant to a written CDTM agreement including, but not limited to:

a. Collect and review patient history, including a medication history and relevant disease state history to manage CDTM services as appropriate per protocol.

b. In the ambulatory setting, monitor vital signs as appropriate per protocol and record pertinent data.

c. Assist the supervising physician or physician designee in an inpatient setting as follows:

i. Record patient progress notes

ii. Order and interpret select laboratory test as outlined in the specific CDTM protocols

iii. Order medications as outlined in the specific CDTM Protocols

iv. Instruct and counsel patients on the use of prescribed drug therapy

SKILLS AND ABILITIES REQUIRED

1. Must have exceptional oral and interpersonal communication skills, to communicate effectively with members of other healthcare disciplines, and other Pharmacy staff.

2. Must be able to plan and coordinate the activities of pharmacy staff in accordance with Policy and Procedures.

3. Must be able to properly motivate and supervise support personnel.

4. Priorities and organizes work while under stress and with time constraints. Must pay attention to detail virtually 100% of work time, and have critical thinking and decision-making skills.

5. Must be able to set and change priorities, and accept additional responsibility as needed.

6. Must be able to respond positively to new approaches and changes in the work environment.

7. Evaluates medical information and retrieves biomedical literature using appropriate search strategies and interprets biomedical literature with regard to study design, methodology, statistical analysis, significance of reported data, and conclusions.

8. Must have extensive knowledge and ability in all areas of the department including: IV Admixtures, Drug Information, Ambulatory, Manufacturing, and Drug Distribution.

9. Must be able to train new employees.

10. Must be capable to assume the responsibility for coordinating pharmacy services on an assigned shift.

11. The individual in this position must demonstrate appropriate knowledge of principles of growth and development over the life span of the neonate, adolescent, adult, and geriatric patient. In addition, they must possess the ability to assess patient data relative to age specific needs and provide care as described in the department's policies/procedures.

12. Must have advanced knowledge of Pharmacotherapy.

13. Ability to work collaboratively as a member of the patient care team.

14. Current Basic Life Support (BLS) certification

15. Performs physical exams when appropriate

Qualifications

QUALIFICATIONS AND COMPTENCIES

1. Must have a Bachelor of Science degree in Pharmacy or Doctor of Pharmacy from an accredited college of pharmacy. Must be eligible for licensure to practice pharmacy in the Commonwealth of Massachusetts.

a. Post graduate residency/fellowship training is preferred.

b. Board Certification by examination in a specialty is preferred

c. Must meet all Board of Pharmacy requirements to enter into a collaborative drug therapy agreement (if applicable, see appendix)

2. Must complete 20 continuing education credits per year to maintain license

3. When applicable, for each year of a CDTM agreement, pharmacists MUST complete at least 5 additional contact hours (i.e., total of 25 contact hours yearly) that address areas of practice generally related to the specific collaborative practice agreement. If there is more than one specific area of practice, it is recommended to obtain additional contact hours in each area, however only 25 total contact hours per calendar year are required.

4. If prescriptive practices are included in the collaborative practice agreement:

a. Maintain a current controlled substance registration issued by the Department during the term of the agreement, pursuant to M.G.L. c. 94C, * 7 and 9 and 105 CMR 700.000: Implementation of M.G.L. c. 94C.

b. Complete pain management training required pursuant to M.G.L. c. 94C, * 18(e) prior to initially obtaining a controlled substance registration and at least biennially thereafter as a condition precedent to renewing his or her pharmacist license

c. Submit an attestation, signed under the pains and penalties of perjury, that the pharmacist participates in, or had applied to participate in, MassHealth as either a provider of services or for the limited purpose of ordering and referring services covered by MassHealth, in accordance with M.G.L. c. 112, * 24B.

5. Pharmacist is in good performance standing based upon feedback from internal or external references when applicable.

6. Upon department orientation, and annually thereafter, must complete:

a. Institutional level competency assessments:

i. OSHA/Fire safety

ii. Patient and Workplace Safety

iii. National Patient Safety Goals

iv. Infection control

v. HIPPA

vi. Hand Hygiene

b. Pharmacy Department competency assessments are based upon areas of staffing and may include:

i. Process-specific skills

ii. Clinical skills

iii. Population/age specific Pharmacotherapy

iv. Sterile Products Preparation

v. Aseptic Technique

vi. Emergency response/Code training

7. Must have a Massachusetts Controlled Substance Registration license, National Provider Index number, and a Drug Enforcement Administration Registration number, if applicable.

EEO Statement Brigham and Women's Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability. Primary Location: MA-Boston-BWH Boston Main Campus Work Locations: BWH Boston Main Campus 75 Francis St Boston 02115 Job: Pharmacist Organization: Brigham & Women's Hospital(BWH) Schedule: Full-time Standard Hours: 40 Shift: Day Job Employee Status: Regular Recruiting Department: BWH Pharmacy Job Posting: Jul 18, 2024