April Hanson, PharmD
Director of Pharmacy
Tyler Healthcare Center
During the first few months of the residency year, my goals included increasing patient safety in dispensing, administering and prescribing, as well as reorganizing the pharmacy to decrease inventory. Another important goal was to increase the collaboration between the pharmacists and other healthcare providers i.e. physicians, nursing. I began this journey by reorganizing the dispensing of medication in the pharmacy. Not only was I making progress by clarifying the hospital’s inventory and reducing confusion for the facility staff, but I was able to develop relationships with members of the healthcare team by spending such a large quantity of time in the pharmacy. The reorganization project involved transitioning to unit dosed medications thereby filling only enough medications for a 24 hour period. Also, the pharmacy inventory was reorganized by generic name to make locating medications easier. Largely due to a more efficient system, during the first 4 months of the residency, the number of medication errors related to dispensing and administrating dropped 10%.
As a full-time pharmacist, the facility was eager to involve me in the committee process for Quality Improvement, Infection Control and Medication safety. I was also in charge of planning and running Pharmacy and Therapeutics (P&T) meetings. Through P&T, we decreased inventory by choosing a preferred proton pump inhibitor and quinolone for the facility as well as developing therapeutic substitution policies and procedures. With the therapeutic substitution policies, I was allowed to write substitution orders for medications in the proton pump inhibitor class and over the counter medications. With increased management and utilization scrutiny, the total cost of pharmacy inventory declined $15,000 from the previous year.
The medical staff at THC was open to my participation in the anticoagulation monitoring and approved a collaborative practice agreement. Dosage adjustments were made by contacting the patient by phone or by seeing them in the clinic. Face-to-face visits were billable and revenue generating for the facility, thus they were the preferred method of patient monitoring.
Because of my unique training as a pharmacist, several departments in the facility asked me to present various topic discussions. These educational sessions helped me develop relationships with other departments and to promote what a pharmacist is capable of doing. As a result of this relationship building, I assisted with giving flu vaccines to both employees and clinic patients and diabetes education for newly diagnosed patients.