Clinical Pharmacist

Job Summary

The Clinical Pharmacist provides direct pharmaceutical care and is considered the major source of pharmaceutical clinical information and is allowed to manage selected patients. Performs or supervises professional pharmacy work including drug selection, compounding and dispensing, bulk compounding of pharmaceutical and stock preparation.


Provides information and consultative services to the medical staff on drugs, their characteristics, dosage, indication, contraindication, adverse reactions, availability of alternative medications, etc. Participates and maintains control and security of narcotics and other controlled substances. Performs other duties as required and assigned.

ESSENTIAL JOB FUNCTIONS

Routine Clinical Duties are performed on a regular basis and involve risk to patient's life, safety, health or well-being. Examples include but not limited to:

1. Conduct medical staff authorized outpatient pharmacy clinics for examination, screening, and treatment of specialized patients. Obtains appropriate health history, follows and adjusts the developed treatment plan, and monitors the patient's outcome to the prescribed treatment plan.
2. Obtains the appropriate history and performs limited physical assessment related to the specialized pharmacy clinics. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, or mental challenges.
3. Document all clinical activities, update medication allergy information, and recommend update to problem lists in the medical record.
4. May order and interpret laboratory tests as needed.
5. May refer to appropriate services as needed via consultations. May provide appropriate treatment plan as described by consultant.
6. Medications will be monitored, titrated, and/or altered per Pharmacy Clinics.
7. Provide pharmaceutical services to focus on therapeutic drug monitoring. Analyze medication regimens to ensure the most effective, least toxic, and most economical treatment plan.
8. Interview patients to ascertain significant past medical history and medication history. Evaluate medication regimens for appropriateness, drug interactions, therapeutic duplications, non-compliance, and adverse drug events.
9. Serve as a therapeutic consultant to the medical staff.
10. Accurate filling and dispensing of prescription and over-the-counter drugs on orders of physician, physician assistant, family nurse practitioner, dentist, and other authorized prescribers.
11. Dispensing over-the-counter drugs per established protocols without the patient seeing the doctor to treat minor ailments.
12. Counseling patients on the use, storage, cautions, and side effects of all medications dispensed as well as documentation of cognitive services provided.

General Areas of Responsibility

Education

Provide formal and informal education and in-services to pharmacy, medical, nursing, and dental staffs as requested. Provide training for pharmacy residents, pharmacy students, and medical students.

Prepare formal lectures for professional in-house student training as requested. Provide education to patients and their families about medications, common disease states, and information on health promotion.

Research

Work with physicians to develop protocols for medical and administrative research related to pharmacy. Direct and/or participate in the preparation of publication articles.

Performance Improvement:

Collaborates with other health professionals to develop treatment protocols, standards of practice and policies. Participates in ongoing quality assurance and performance improvement activities including audits, chart reviews, development of review criteria.

JOB FACTORS

Six (6) job factors identify additional job performance requirements beyond routine Pharmacist Job Functions: supervisory controls, guidelines, scope and effect, personal contacts, and purposes of contact.

Factor 1: Supervisory Controls

The Chief Pharmacist sets the overall program objectives. Incumbent is self-directed and must exercise latitude in planning to carry out health care assignments that may involve undertaking new procedures, practices and approaches. Incumbent must consult with other members of the medical staff on a routine basis to develop the best patient treatment plan. The majority of work is not reviewed at the time the care is provided. Incumbent has the responsibility for planning and carrying out these objectives independently and interpreting policy on own initiative in terms of established objectives. He / she keeps the supervisor informed of progress and potentially controversial matters of far-reaching implications. Completed work is reviewed and evaluated periodically. The professional work is reviewed on the basis of effectiveness and compatibility in providing pharmacy services.

Factor 2: Guidelines

Works within the framework of established guidelines and standards of care or protocols. However, guidelines are not completely applicable to every situation. Incumbent must use judgement in interpreting and adapting guidelines to achieve the desired patient outcome. Guidelines available include:

• Medical Staff standards of care, protocols, federal and state regulations and IHS manual issuances and policy and procedures;
• AAAHC Accreditation Standards;
• Conditions on Medicare-Medicaid Participation;
• KIC Pharmacy Policy and Procedure Manuals, standing orders and protocols and Personnel Guide for Supervisors.

While there may be specific guidelines, the individual uses judgement in interpreting and adapting these guidelines to patient needs and health center management.


Factor 3: Complexity

The work typically includes varied duties requiring many different and unrelated processes. Decisions regarding what needs to be done includes the assessment of unusual circumstances, variations in approach and incomplete or conflicting data. The work requires independent judgement wherein error could result in serious injury or death to a patient. Work covers assessment, medical history, development and implementing of care plans, evaluation of the effectiveness of treatment and modification or change of treatment. Identifies fine differences between drugs as they relate to the therapeutic efficacy of the product. Prior to dispensing, reviews the patient's medical record for therapeutic appropriateness including diagnosis/treatment and patient allergy (drug interaction screening). As necessary, suggests alternative medications to avoid incompatibilities, alleviate side effects, overcome potentiating drug combinations and prevent antagonistic reactions. Participates in inter and intradepartmental training programs for such groups as physicians, physician's assistants, and nurses.

Factor 4. Scope and Effect

The purpose of the work is to provide quality clinical pharmacy services and assure that acceptable pharmaceuticals are used in a program of rational drug therapy. Incumbent consults with the prescribing medical provider ensuring that correct and cost-effective therapy is initiated, resulting in cost savings in drugs purchased and a decrease in medical risk and legal liability for inappropriate drug therapy. The work affects the patient's health and error in judgement could result in serious injury or death to a patient. Responsibilities include patient assessment of clinical-pharmaceutical needs, planning for the pharmaceutical needs, and teaching pharmacy patients and their immediate families; the work directly affects the health and well-being of individual patients, families, patient groups, and impacts on the total community.

The scope of the clinical pharmacist non-routine responsibilities and prescriptive authority will be determined and granted in writing, by the Clinic Medical Director. Prescriptive authority will be granted in writing to the Clinical Pharmacist Specialist, consistent with their documented and approved scope of practice and will not require physician co-signatory. Clinical (primary care) privileges will be determined and granted in writing to the clinical pharmacist, by the Medical Director

Factor 5. Personal Contacts

Contacts are with patients, families, physicians, other health professionals, other health clinic staff members, general public, business representatives, community / tribal leaders, and health oriented community representatives. Incumbent serves as preceptor for students and provides educational programs to the entire health professional staff, specific patients, and tribal groups. Represents the pharmacy in meetings with other professional organizations, public meetings, or drug industry representatives.

Factor 6. Purposes of Contacts

The contacts are generally to:

• Explain and review treatment care plan and desired outcomes;
• Provide a broad range of professional expertise regarding clinical pharmacy and pharmaceuticals;
• Ensure safe and effective compliance with drug regimen, monitor chronic drug therapy, and provide pharmacy-based acute care services;
• Provide health education presentations on a wide variety of health / pharmacy related subjects;
• Elicit information from individuals regarding their company's products and services available;
• Establish good public relations in order to carry out the goals and objectives of the clinic.

KIC COMPETENCIES

Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.

Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition.


Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers, always talk and act with customers in mind; and recognize working colleagues as customers.


Effective Communication: Ensure important information is passed to those who need to know; convey necessary information with respect, clearly and effectively orally or in writing

Responsiveness and Accountability : Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

Knowledge, Skills, and Abilities

• Knowledge of Indian Health Service policies and procedures. Applies understanding of the clinical, management process, and general management skills;
• Knowledge of the physical and chemical properties and characteristics of substances, therapeutic action of drugs, and the principles of chemical, biological, pharmacological and biopharmaceutical science;
• Knowledge of drug literature evaluation and research design, pharmacology, pathophysiology, advanced pharmacotherapeutics, pharmacokinetics, and advanced clinical pharmacy practice to provide patient care drug therapy;

Knowledge, Skills, and Abilities ( Cont.)

• Knowledge in planning, monitoring, and evaluating drug therapy in a clinical setting;
• Knowledge of the diagnostic, preventative, and therapeutic approaches related to the various chronic disease states for which specialized pharmacy clinics are created;
• Knowledge of communication techniques to organize and present technical information to patients, professional colleagues, students, and others;
• Knowledge of research methodologies, protocol design, and implementation.
• Knowledge and ability to carry out rules of Health Insurance Portability and Accountability Act (HIPPAA), which protects patient rights;
• Ability to collect, organize, record, and communicate in a meaningful way, relevant primary health assessments, medical history, physical findings, and selective laboratory tests to function as an independent practitioner within the medical staff approved pharmacy clinic;
• Ability to communicate with patients regarding the disease state, desired outcomes, laboratory tests, proper administration, use, actions, precautions, and storage of their medications;
• Ability to communicate with other health providers in respect to patient total treatment plan;
• Ability to identify and develop educational activities related to patient care for all Health Professionals and Health Professional Students.
• Ability to exercise mature judgment in evaluating specific situations, and recommending solutions;
• Ability to establish and maintain effective working relations with patients, peers, public / private agencies, Tribal members, and the general public.

Physical Activities Include

Must be able to hear. Specific vision abilities include close, distance, color, peripheral, depth perception, and the ability to adjust focus. Ability to use hands to finger, handle or operate objects tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch; and taste or smell. Each of the listed activities also requires standing, sitting, walking, bending, and stooping, climbing on stools and ladders, and routinely lifting and carrying items and boxes up to ten (10) pounds.

Writing by hand and using a personal computer. Long hours standing and/or in front of computer screen. Traveling occasionally, to out-of-town meetings and functions.

Working Environment

Work is performed in ambulatory clinic and / or pharmacy environment. Exposure to infectious and contagious disease is common. May be required to wear specialized personal exposure equipment or clothing to prevent exposure to blood and body fluids.


Safety precautions for employees including blood draw for screening of various diseases such as hepatitis, required immunizations, etc., are necessary. Employee is required to have vaccination for Hepatitis B. The employee is occasionally subject to verbal abuse, threats, and physical violence from angry, hostile, or disgruntled patients and/or family members.

Education

Graduate from an ACPE approved college or university pharmacy program. Must have completed one of the following:

1. Doctor of Pharmacy degree, which includes professional knowledge of the theories, principles, practices and techniques of clinical and basic pharmacy to provide direct clinical-pharmaceutical patient services.
2. A Bachelor of Science in Pharmacy which includes professional knowledge of the theories, principles, practices and techniques of clinical and basic pharmacy to provide direct clinical-pharmaceutical patient services. Minimum two (2) years pharmacy experience required.

Licensure

Employee must have a current, permanent, full, and unrestricted license to practice pharmacy in the State of Alaska, another state, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

Experience

Specialty board certification or completion of an ASHP or APHA hospital or ambulatory pharmacy residency or National Certification in one (1) chronic disease states is preferred, or ability to obtain within two (2) years of hire date.