Joint-Effort Clinical Pharmacy Services in Rural Hospitals

Abstract

Studies in the literature support the practice of having clinical pharmacists work in direct patient care and the value of these services within the health care system.1,2 Although most pharmacists want to provide pharmaceutical care in collaboration with other health care professionals, some hospitals lack the staff that would be necessary. In Canada, the burden of a recently documented shortage of pharmacists3 has been felt across the country, but it has also prompted the innovative use of pharmacy technicians and expansion of their role.4-6 For example, some rural hospitals have empowered pharmacy technicians to fulfill medication dispensing requirements in rural settings, without on-site pharmacists. A clinical pharmacy technician has been described as a technician who takes on the clerical responsibilities of the pharmacist7 (including medication historytaking, 6 drug-use evaluation, investigational drug services,4 and clinical management tasks5), thereby allowing the pharmacist to provide more clinical services. Most experiences with this practice model have been in larger centres where pharmacists are on site.4-6 Rural centres present a unique opportunity to enhance patient care at sites where a pharmacy technician is present but clinical pharmacy services would not otherwise be possible. This model may free up pharmacist time for other tasks, enhance patient care, increase the number of proactive interventions by an off-site pharmacist, and increase utilization of pharmacy technicians’ skills at a time when pharmacists are in short supply. With direction and training, technicians would be able to alert nurses to potential pharmaceutical problems and triage problems for the clinical pharmacist (i.e., assign values to problems and alert the pharmacist according to their severity and urgency). Technicians would also be able to collect information more efficiently, giving off-site pharmacists more time to review patients at their own sites. A project was conceived whereby an off-site pharmacist would work with on-site pharmacy technicians to provide clinical pharmacy services intended to optimize patient care. The purpose of the project was to increase and assist with pharmacists’ clinical interventions by educating pharmacy technicians to identify clinical pharmacy problems and collect patient information.