Hospital Pharmacy Practice Research Articles

Pharmacy practice and policy research in Türkiye: a systematic review of literature.

In recent decades, there has been an interest in clinical pharmacy practice in Türkiye with emerging studies in this area. Despite the recent emergence of diverse pharmacy practice studies in Türkiye, a comprehensive assessment of overall typology of studies and impact has not been conducted thus far. This systematic review aims to document and assess pharmaceutical policy and practice literature published within the last 5 years in Türkiye. The other aim is to summarise the expected impact of published studies on policy and practice research. The systematic review was conducted according to the guidelines described in the PRISMA Statement. A comprehensive search approach, incorporating Medical Subject Headings (MeSH) queries and free-text terms was employed to locate pertinent literature related to pharmacy practice and policy in Türkiye. The search covered the period from January 1, 2019, to January 1, 2024, and involved electronic databases including PubMed, Medline Ovid, Scopus, ScienceDirect, Springer Link, PlosOne, and BMC. In the final grouping, 73 articles met the inclusion criteria and were selected for this review. Among the quantitative studies, majority studies were cross-sectional survey studies. Through the rigorous thematic content analysis seven research domains were developed from the selected literature: drug utilisation and rational drug use, the emerging role of pharmacist, access to medicines and generic medicines, community pharmacy practice, pharmacovigilance/adverse drug reactions, and pharmacoeconomic studies. The pharmacist role is evolving; however, several challenges remain in fully realising the potential of pharmacists. These include regulatory barriers, limited public awareness of pharmacists' expanded roles, workforce capacity issues, and the need for ongoing professional development and training. Research studies are needed in the areas of generic prescribing, medicine adherence, intervention studies in community and hospital pharmacy practice, and on pharmacoeconomics and pharmacovigilance.

Trend analysis of pharmacist involvement in cancer care in Japan from 2015 to 2020: A nationwide survey study on hospital pharmacy practice.

Pharmacists are needed as members of oncology teams. The Japanese Society of Hospital Pharmacists (JSHP) conducts a nationwide survey annually to analyze the actual situation and generate fundamental information about hospital pharmacy practice in Japan. Using data from this large-scale survey, we described pharmacists' involvement in cancer chemotherapy. We explored the factors related to the acceleration of pharmacists' tasks or involvement in clinical practice, primarily in oncology. Data were obtained from annual surveys conducted by JSHP from 2015 to 2020. All variables were expressed as categorical variables and tabulated. The Chi-square and Fisher's exact tests were used to compare the categorical variables. The Cochran-Armitage trend test was used to identify significant trends. From 2015 to 2020, 22,362 responses were recorded. After applying the exclusion criteria, 20,906 were analyzed. The proportion of hospitals enrolling pharmacists with oncology-related certifications significantly increased in all hospitals providing cancer care. Multivariable logistic regression analysis indicated that a smaller number of beds per pharmacist significantly correlated with additional fees for outpatient pharmacy services (p = 0.0002 for trend). Hospitals charging increased fees for outpatient oncology pharmacy services were associated with a smaller number of beds per pharmacist, regardless of hospital size. A balance between the number of beds and pharmacists, particularly certified oncology pharmacists, is crucial for safe and high-quality cancer treatment.

[Translated article] Hospital pharmacy towards 2030

Hospital Pharmacy is today a profession marked by therapeutic advances, with a proactive attitude, focussed on people and their health. The evolution of processes is constant, with the full presence of digitalisation, robotisation, and even artificial intelligence, in an environment that also requires the efficient and sustainable use of these tools. In this context, it is necessary to have a roadmap that guides the advancement of the profession and Hospital Pharmacy Services.Continuing with the philosophy of the 2020 initiative which, with the slogan “Towards the future, safely”, defined the strategic lines to advance in the improvement of Hospital Pharmacy practice, the Spanish Society of Hospital Pharmacy wanted to raise the challenges the profession is currently facing and with a view to 2030.With this strategic planning objective, 20 challenges have been identified and developed, which cover the different areas of action and involvement of Hospital Pharmacy and which cover clinical activities, transversal aspects, training, and research, as well as areas related to people and to the organisations or health systems. For each of them, the objectives, standards, tools, and resources have been defined. It is also planned to provide tools that facilitate monitoring of implementation and the impact on the profession, patients, and the environment.

La farmacia hospitalaria rumbo al 2030

Hospital pharmacy is today a profession marked by therapeutic advances, with a proactive attitude, focused on people and their health. The evolution of processes is constant, with the full presence of digitalization, robotization and even artificial intelligence, in an environment that also requires the efficient and sustainable use of these tools. In this context, it is necessary to have a roadmap that guides the advancement of the profession and hospital pharmacy services.Continuing with the philosophy of the 2020 initiative which, with the slogan “Towards the future, safely”, defined the strategic lines to advance in the improvement of hospital pharmacy practice, the Spanish Society of Hospital Pharmacy wanted to raise the challenges the profession is currently facing and with a view to 2030.With this strategic planning objective, twenty challenges have been identified and developed, which cover the different areas of action and involvement of hospital pharmacy and which cover clinical activities, transversal aspects, training and research, as well as areas related to people and to the organizations or health systems. For each of them, the objectives, standards, tools and resources have been defined. It is also planned to provide tools that facilitate monitoring of implementation and the impact on the profession, patients and the environment.

Construction and Practice of Hospital Pharmacy Practice Teaching Mode under the Reform of DRG Payment Method

Objective: this research for DRGs payment reform, in order to build a new teaching mode of traditional pharmacy practice and DRGs payment reform background, the pharmaceutical interns add DRGs disease grouping and ICD disease coding teaching and DRGs disease grouping of pharmacoeconomics teaching, training more able to adapt to the medical reform of drug service personnel and hospital performance management and internal cost control training practical pharmaceutical service talents. Methods: Through the implementation of different internship programs, to make the effect evaluation. Results: Combining the traditional clinical pharmacy practice with the background of DRGs payment reform, the teaching of DRGs disease grouping, ICD disease coding teaching and pharmacoeconomics of DRGs disease grouping. Conclusion: In this study, the practice of Chinese pharmacy, prescription practice, clinical pharmacy and ward practice combined the teaching of DRGs disease grouping and ICD disease coding with the medical insurance department, which promoted the smooth implementation of DRGs and reflected the value of clinical pharmacists in ensuring effective, safe and economical drug use.

Implementation of Virtual Interactive Cases for Pharmacy Education: A Single-Center Experience.

Patient case simulation software are described in pharmacy education literature as useful tools to improve skills in patient assessment (including medication history-taking and physical assessment), clinical reasoning and communication, and are typically well-received by students and instructors. The virtual interactive case (VIC) system is a web-based software developed to deliver deliberate practice opportunities in simulated patient encounters across a spectrum of clinical topics. This article describes the implementation and utilization of VIC in the undergraduate curriculum at one Canadian pharmacy school. Methods: At our facility, the use of VIC was integrated across the training spectrum in the curriculum, including core and elective didactic courses and practice labs, experiential learning, interprofessional education, and continuing education. Its use was evaluated through student and instructor surveys and qualitative student interviews). VIC is easy to navigate and created a positive and realistic learning environment. Students identified that it enhanced their ability to identify relevant patient information, accurately simulated hospital pharmacy practice and thereby helped them to prepare for their upcoming experiential courses. The use of VIC has expanded beyond its original intended purpose for individual student practice to become a valuable addition to pharmacy undergraduate education. Future plans include ongoing development of cases and exploration of further uses of VIC within the didactic curriculum, for remediation in experiential courses, and for pharmacist continuing education.

Using machine learning or deep learning models in a hospital setting to detect inappropriate prescriptions: a systematic review

ObjectivesThe emergence of artificial intelligence (AI) is catching the interest of hospital pharmacists. A massive collection of health data is now available to train AI models and hold the promise...

Documentation and classification of hospital pharmacist interventions: A scoping review.

The practice of documenting pharmacist interventions (PIs) has been endorsed by many hospital pharmacists' societies and organizations worldwide. Current systems for recording PIs have been developed to generate data on better patient and healthcare outcomes, but harmonization and transferability are apparently minimal. The present work aims to provide a descriptive and comprehensive overview of the currently utilized PI documentation and classification tools contributing to increased evidence systematization. A systematic literature search was conducted in PubMed, Scopus, Web of Science and the Cumulative Index to Nursing and Allied Health Literature. Studies from 2008, after the release of the Basel Statements, were included if interventions were made by hospital or clinical pharmacists in a global hospital setting. Publications quality assessment was accomplished using the Mixed Methods Appraisal Tool. A total of 26 studies were included. Three studies did not refer to the documentation/classification method, 10 used an in-house developed documentation/classification method, seven used externally developed documentation/classification tools and six described method validation or translation. Evidence confirmed that most documentation/classification systems are designed in-house, but external development and validation of PI systems to be used in hospital practice is gradually increasing. Reports on validated PI documentation/classification tools that are being used in hospital clinical practice are limited, including in countries with advanced hospital pharmacy practice. Needs and gaps in practice were identified. Further research should be conducted to understand why using validated documentation/classification methods is not a disseminated practice, knowing patients' and organizational advantages.

Impact of a systematic framework for anticipatory compounding on medication waste reduction in a mid-size community hospital.

In current hospital pharmacy practice, the need to compound medications ahead of patient orders often results in an increase in medication waste. The purpose of this study was to implement a strategic approach for anticipatory sterile compounding and evaluate its effect on the reduction of expired medication waste. This was a pre-/post-intervention quasi-experimental study with 3 weeks of data collection for both arms and a 1-week washout period to implement process changes. A par log was placed on the medication storage refrigerator used for anticipatory compounding, with minimum and maximum levels determined by the demand-forecasting model. The primary outcome was the percentage of observations associated with waste. The secondary outcomes were the overall percentage of sterile compounding spending attributable to waste, median wasted dollars per sterile compounded product, and median dollars spent per sterile product compounded as anticipatory stock. Descriptive statistics were calculated using Minitab version 20, with the α level set to 0.05. A total of 4,619 observations were included in the analysis: 2,433 in the preintervention group and 2,186 in the postintervention group. Despite the median price being higher in the postintervention group than in the preintervention group, both the primary and secondary outcomes indicated that waste was reduced following the intervention. Overall, implementation of the framework reduced sterile products waste at our institution. More research is needed to evaluate the effects of this framework at institutions of different sizes and with different patient populations. Further research on probabilistic models for sterile compounded products is also needed.

Spanish Society of Hospital Pharmacy Position Statement on Telepharmacy: Recommendations for its implementation and development

The use of information and communication technologies have nowadays become part and parcel of hospital pharmacy practice. Against this background, it is hardly surprising that Telepharmacy has sparked the interest of a large number of stakeholders. In this respect, the Spanish Society of Hospital Pharmacy has developed a definition of the concept and outlined the conditions under which Telepharmacy should operate. It has also shared its institutional stance on the subject through a position statement that states that Telepharmacy is the provision of pharmaceutical care at a distance through information and communication technologies. Telepharmacy practice includes activities such as therapeutic validation, drafting of clinical documents, provision of pharmaceutical care, therapeutic follow-up, adherence monitoring, drug education and information, coordination between healthcare providers and evaluation of health outcomes. The clinical tasks performed as part of Telepharmacy practice must adhere to a standardized procedure and revolve around the patient's clinical record. Access to Telepharmacy must be provided without discrimination. The service comprises four main activities: pharmacotherapeutic follow-up; patient and caregiver-directed education and information-dissemination; coordination with healthcare providers from the same or different hospitals; and remote informed home drug delivery. Implementation of Telepharmacy requires an adjustment of human (training and capacity-building) and technological resources (validation, interoperability, confidentiality). It must also comply with the laws and regulations in force both at a regional and a national level. Telepharmacy procedures must also be adapted to the relevant ethical standards and codes of good practice. Appropriate indicators must be used to evaluate the performance of Telepharmacy and its impact on health outcomes. According to Spanish Society of Hospital Pharmacy Telepharmacy is a necessary complementary tool to provide specialized pharmaceutical care and thereby improve health outcomes and maximize patient safety and satisfaction.

Association between Pharmacists' Country of Qualifying Education and Practising in a Hospital Setting: A Cross-Sectional Ontario Study.

It is hypothesized that international pharmacy graduates (IPGs) are underrepresented in more clinically challenging work. To examine the association between country of qualifying education for pharmacists in Ontario and the likelihood of practising in a hospital setting. This study was based on publicly available data from the Ontario College of Pharmacists website, specifically records for all Ontario pharmacists with authorization to provide patient care and for whom country of qualifying education and an accredited pharmacy as a place of practice were reported. Pharmacists who met the inclusion criteria were categorized as Canadian graduates or IPGs. The odds ratio (OR) and 95% confidence interval (CI) for reporting hospital pharmacy as a place of practice were estimated by fitting a logistic regression, with adjustment for gender and years since graduation. A total of 14 689 pharmacists were included in the study: 7403 (50.4%) Canadian graduates and 7286 (49.6%) IPGs. These pharmacists worked in a total of 5028 accredited pharmacies (243 hospital pharmacies [4.8%] and 4785 community pharmacies [95.2%]). Among Canadian graduates, 2458 (33.2%) reported at least 1 hospital pharmacy practice site, whereas the proportion was much smaller among IPGs (427, 5.9%). Canadian graduates represented 85.2% (2458/2885) of all pharmacists who reported hospital practice. The estimated crude OR for practice in a hospital pharmacy was 7.98 (95% CI 7.16-8.91), and the adjusted OR was 7.12 (95% CI 6.39-7.98). IPGs may face barriers impeding their ability to practise in a hospital setting. Providing opportunities such as structured clinical training and experiential placements may facilitate integration of IPGs in institutional settings.

Selecting performance indicators for hospital pharmacy practice: A Canadian initiative

AbstractActivity‐based funding is a method of funding hospitals according to the type and volume of services provided and adjusted to their patient population. Currently, pharmacy practice is mainly evaluated with costs and volumes, which are insufficient to properly measure the contribution of pharmacists. Facing the province of Quebec statewide implementation of activity‐based funding, expert committees were set up to develop a set of indicators using a predefined framework to assess pharmacy performance throughout all hospital activities and patient care. Through consultations, partners and stakeholders showed strong support for the initiative, putting more emphasis on the assessment of appropriateness as well as quality and safety. Among the different roles of pharmacists, respondents favoured the assessment of the pharmaceutical care and education of trainees and colleagues. Of the 150 candidate indicators initially identified, 24 were selected, of which 13 were prioritised for experimentation.

EVALUATING HOSPITAL PHARMACY PRACTICE: MEDICATION PRESCRIBING, TRANSCRIBING, AND ADMINISTRATION IN TABUK REGION, SAUDI ARABIA

EVALUATING HOSPITAL PHARMACY PRACTICE: MEDICATION PRESCRIBING, TRANSCRIBING, AND ADMINISTRATION IN TABUK REGION, SAUDI ARABIA

Cardiology pharmacy practice in Saudi Arabia: Historical evolution, current status, and future directions

AbstractThe pharmacy practice in Saudi Arabia has improved over the past two decades. Cardiology pharmacy practice was among the pharmacy practice specialties that witnessed steady improvement. A number of cardiology residency programs have been introduced in recent years, which has led to this steady growth in cardiology pharmacy practice. The current model of cardiology pharmacy practice in major hospitals in Saudi Arabia matches the model used in the United States. Nevertheless, more studies illustrating the value of clinical pharmacists' work with cardiovascular disease management are needed in Saudi Arabia. Saudi Arabia's high prevalence of cardiovascular diseases presents a unique opportunity for cardiovascular clinical pharmacists to illustrate and expand the role they play at the individual and population levels. Moreover, Saudi Arabian cardiology pharmacy practice models need to be described to explain their growing importance. The purpose of this review is to provide an overview of cardiology pharmacy practices’ historical evolution and their current status. In addition, we highlighted some challenges that continue to exist despite the development of cardiology pharmacy research, training, and education. Lastly, we discussed several strategies for overcoming these challenges and expanding the integral role of cardiology clinical pharmacists in Saudi Arabia.

Evaluating Hospital Pharmacy Practice: Medication Prescribing, Transcribing, and Administration in Tabuk Region, Saudi Arabia

Evaluating Hospital Pharmacy Practice: Medication Prescribing, Transcribing, and Administration in Tabuk Region, Saudi Arabia

Pharmacy practice in hospital settings in GCC countries: Dispensing and administration

PurposeTo outline dispensing and administration practices in hospital pharmacy across the Gulf Cooperation Councils (GCC) countries’ hospitals. Paucity of data in appraising hospital pharmacy practice in GCC regions motivated us to conduct this study. MethodsA modified survey questionnaire was prepared from the American Society of Health-System Pharmacist (ASHP) survey questions. Three major domains of questions for general characteristics of the medication use process for dispensing and administration were identified. These were, (1) medication distribution system, and medication distribution technology, (2) technology used to compound sterile preparations, compounding I.V. medication and method of compounding nutrition support preparations, (3) medication administration practices, medication orders, medication administration records (MARs), and technician activities. A list of hospitals was obtained from the Ministry of Health of the targeted GCC countries. A secure invitation link containing a survey questionnaire was sent to the participants directly. ResultsSixty-four hospitals responded to this survey. The overall response rate was 52%. Most surveyed hospitals have centralized inpatient medications distribution system (75.0%). About 37.5% of hospitals used automated dispensing cabinets (ADCs) in their patient care areas. Compounding sterile preparations in the pharmacy, barcode verification technology, workflow management technology, and robotic technology were used by 17.2%, 15.6%, and 4.7% of hospitals, respectively. In using safety technology for medication administration, almost all hospitals have partially or completely implemented an electronic health record (EHR). About 40.6% of hospitals used electronic medication administration records (e-MARs), 20.3% used bar-code-assisted medication administration (BCMA), and 35.9% used smart infusion pumps. ConclusionThe results of this survey revealed an opportunity to improve the medication use management process on dispensing and administration practices in hospitals in GCC countries.

Developing and piloting a cross-sectoral hospital pharmacist intervention for patients in transition between hospital and general practice.

Healthcare is challenged by a rapidly growing group of patients with multi-morbidity and polypharmacy. Increasing activity and specialization puts pressure on healthcare sectors. Medication errors in cross-sectoral transition of patients are often seen. The aim of the study was to explore drug-related problems (DRPs) in the transition of patients between sectors and to develop and pilot-test a cross-sectoral hospital pharmacist intervention to overcome some of these problems. DRPs in cross-sectoral transitions were explored from four perspectives; the literature, the primary and secondary healthcare sector and the patients. An intervention was developed from the findings through co-creation between pharmacists, doctors and a nurse. The intervention was piloted and evaluated from data on the included patients and the activities performed. DRPs in transitions from general practice (GP) to hospital were caused by inadequate focus on updating the Shared Medication Record (SMR). For patients being discharged, DRPs were described with multiple facets; for example, missing information on medication changes, lacking patient involvement and problems with dose-dispensed medicine or electronic prescriptions. An intervention with a pharmacist in a shared employment between Hospital Pharmacy and GP was developed and piloted. The intervention included medication reconciliation and updating SMR for patients referred to hospital; and medication review, overview of medication changes and follow-up telephone calls for patients discharged from hospital. The intervention identified and solved several DRPs; in this way, medication errors were avoided. Access to health records in both sectors was important in the identification and resolution of DRPs. DRPs in cross-sectoral transitions are multifaceted and the experiences depend on the point of view. The cross-sectoral hospital pharmacist intervention identified and solved several DRPs and medication errors were avoided. The intervention made sense to both healthcare sectors and patients. Shared employment and unique access to health records in both sectors showed to be of importance in the identification and resolution of DRPs. Development and pilot-test of a pharmacist intervention for patients in transition between hospital and general practice Background: Healthcare is challenged by a rapidly growing group of patients with multiple chronic diseases treated with several drugs at the same time. The aim of the study was to explore drug-related problems in the transition of patients between the hospital and patients' general practitioner and to develop and pilot-test a pharmacist intervention to overcome some of these problems.Methods: Drug-related problems in patient transitions were explored from the perspectives of the hospital, the general practitioner, the patients and the literature. An intervention was developed from the findings by pharmacists, doctors and a nurse. The intervention was pilot-tested and evaluated from the descriptions of the included patients and activities performed.Results: Drug-related problems in transitions from general practice to hospital were caused by inadequate focus on updating the Shared Medication Record.For patients being discharged, drug-related problems were related to for examplemissing information on medication changessparse involvement of the patient in their own treatmentproblems with medicine dispensed on a dose dispensing machine at the local pharmacy.An intervention with a pharmacist in a shared employment between Hospital Pharmacy and general practice was developed and piloted. The intervention includedtalking to the patient about their medication and updating the Shared Medication Record for patients referred to hospitalmedication review, overview of medication changes and follow-up telephone calls for patients discharged from hospital to general practice.The intervention identified and solved several drug-related problems. Access to health records in both the general practice and at the hospital was important in the identification of drug-related problems.Conclusions: Drug-related problems in cross-sectoral transitions are multifaceted. The pharmacist intervention identified and solved several drug-related problems. The intervention made sense to the general practitioner, hospital and patients. Shared employment and unique access to health records in both the general practice and at the hospital showed to be of importance in the identification of drug-related problems.

Implementing the pharmacy technician role in existing pharmacy settings: Stakeholders views of barriers and facilitators.

The field of pharmacy will benefit from pharmacy technicians, a higher educated mid-level support workforce. They support pharmacists in providing pharmaceutical patient care through delegated roles and responsibilities. Empirical research on pharmacy technicians within pharmacy practice community and hospital pharmacy practices tends to focus on the practical outcomes of this workforce addition. It mostly addresses the 'WHAT' of service delivered by pharmacy technicians. Literature on the 'HOW' of their role development in practice is scarce. Furthermore, it seems difficult for most pharmacy technicians to effectively fulfil this professional role. This qualitative study explored factors influencing role development of pharmacy technicians in community and hospital pharmacies. On site, individual and small-group interviews were conducted with pharmacy technicians (n=10), and two colleagues: pharmacists (n=7) and pharmacy assistants (n=6). Interviews were based on a semi-structured interview guide. Participants were asked to describe specific incidents and organisational, relational and pharmaceutical care perspectives, illustrative of the process of developing and implementing the pharmacy technician role. Template analysis was used to develop a list of codes representing themes identified in the data. Five interrelated themes influenced development and implementation of the pharmacy technician role. Two of them were at a more contextual level: (a) experiencing a lack of vision on added value of the new role within the field of pharmacy and (b) learning climate. The other three were related to personal interactions between staff members: (c) role expectations and organisational fit, (d) personal traits of pharmacy technicians and (e) support of pharmacy technicians through task delegation and role enhancement. The data showed that development and implementation of pharmacy technician roles is a complicated process. A detailed plan for addressing and remediating the five identified themes is important to promote role development of pharmacy technicians.

Pharmacy Education: Upgradation and Clinical Rotation to Produce Quality Professionals in Pakistan

Pharmacy is an expanding profession with new and expanded duties for pharmacists. Pharmacology training should adjust to local and global trends to graduate quality pharmacists1. The five years of basic pharmacy education is inadequate for excellent quality of treatment, which might impair patients' health. Several nations, including the USA, have expanded basic pharmacology training to 6 years and established Pharm D as entrance level for any area of practice2. Countries that have implemented postgraduate training produce practice-ready pharmacists in varied sectors, depending on specialty and local requirements. Regional pharmacy authorities supply a large number of institutional rotation locations for pharmacy students, whereas hospital rotations have become a career necessity3. This rotation aims to provide students experience as pharmacists in a multidisciplinary context. The rotation's goals and activities include comprehending patients' drug-related requirements, pharmacists' regulatory, ethical, and professional duties, and medication distribution4. This clinical rotation offered a number of issues for institutions, especially in offering possibilities for students to engage in the pharmacist's job. Students should perform a set of specific clinical activities for which they are educated in hands-on workshops, followed by observation by a clinician or physician. Students do activities under indirect supervision after skill assessment. This technique lets students participate in direct medical care and help specific patients.5The duration of the rotation is inadequate for skill development, thus students must do duties under indirectly supervision of the institution's physician to begin hospital pharmacy practice.

Developing pharmacy services in a home hospital program: The Mayo Clinic experience.

PurposeHome hospital programs are rapidly becoming a more common patient care model in the market. The impact on hospital pharmacy practices is not well defined. This article describes the development of pharmacy services in a home hospital program in an attempt to help other organizations create their own home hospital pharmacy programs.SummaryCaring for acutely ill patients in their home was a novel idea when Mayo Clinic began considering this in January 2020. Since then, the coronavirus disease 2019 (COVID-19) pandemic has rapidly escalated interest in and pursuit of these programs. One question we asked ourselves, and many colleagues are asking us today, is “How does pharmacy fit in?” Through 2 years of active engagement, innovation, and persistence, our team has developed a robust pharmacy presence in the home hospital care team and a well-articulated approach to medication management for our patients. We have tightly aligned and blended our clinical efforts to mirror our typical inpatient and ambulatory care clinical activities. We have also developed and modified our dispensing functions to serve the unique needs of the care model.ConclusionHome hospital medication management is both complex and ripe with opportunities for pharmacy engagement.