Barnstorming, Directing, Producing: Integration of a Clinical Pharmacist Across the Full Spectrum of Palliative Care Services (341): Program Chiefs SIG

Abstract

Objectives 1. Compare clinical pharmacist goals of care with HospiceMedicareConditions of Participation. 2. Create a cost-benefit analysis for initially incorporating a palliative care pharmacist in their program and the subsequent role of the clinical pharmacist across the full spectrum of palliative care. 3. Describe the team, patient-centered, and program outcomes of having a clinical pharmacist integrated into hospice and palliative care interdisciplinary care teams. This presentation will focus on the role, benefits, outcomes, and costs of providing active clinical pharmacist involvement across the entire spectrum of interdisciplinary teams in an integrated hospice and palliative care (HPC) program. Given the burdens of illness, frailty, and polypharmacy borne by HPC patients, medication side effects, interactions, and cost become central concerns. Palliative care and pharmaceutical care both focus on achieving the best quality of life for patients and families in the setting of their choice. Incorporating a pharmacist directly into the interdisciplinary care of HPC patients across all sites of care is a logical step in the comprehensive management of symptoms in a safe and cost-effective manner. Presenters will describe how a pharmacist can be successfully integrated into the care of patients across the full spectrum of HPC services including inpatient and extended care facility palliative care consult services, an inpatient acute palliative care unit, a palliative care outpatient clinic and home, and long term careebased hospice care. The pharmacist serves as a resource for drug information in this patient population for which evidence-based guidelines are limited and where reliable routes of medication administration change frequently. The pharmacist works with physician and nurse members of the inpatient and outpatient services to capitalize on available evidence to develop and revise cost-effective and consistent medication options for inpatient and outpatient symptommanagement protocols. Central to the pharmacist role is patient, staff, and physician education and collaboration regarding the safe and effective use of medications which may be off-label and outside the comfort level of healthcare providers and caregivers. Outcomes presented will include job descriptions, net cost savings achieved, protocols developed, and staff satisfaction with the program. Presenters will also advocate for expanding specificHPC training and certification programs for pharmacists.