Pharmacist (Clinical Specialist)

Department of Veterans Affairs

The Co-Managed Care (CMC) Pharmacist is a licensed professional with knowledge and proficiency in pharmacy practice including pharmaceutics, pharmacokinetics, pharmacodynamics and pharmacotherapeutics. The incumbent is responsible for analyzing real and potential drug-related medical problems and implementing corrective action to ensure that patients receive optimal drug therapy.

• **OPEN TO CURRENT FACILITY EMPLOYEES ONLY** FUNCTIONS OF SCOPES OF PRACTICE a. Clinical 1) The pharmacist provides appropriate selection of drug therapy based upon the pharmaceutical principles of pharmacokinetics and pharmacodynamics; monitoring for efficacy, side effects and clinical outcome; and advises prescribers, as appropriate. 2) Provides patient-specific therapeutic drug monitoring and communicates relevant findings and / or recommendations to other health care providers in charge of the patient both orally and in writing. Monitoring will include prospective review and intervention in: Therapeutic appropriateness of a patient's drug regimen Therapeutic duplication in the patient's drug regimen Appropriateness of the route and method of administration Degree of patient compliance with the prescribed drug regimen Drug-drug, drug-food, drug-laboratory, or drug disease interactions Clinical and pharmacokinetic laboratory data to evaluate the efficacy of drug therapy and to anticipate side effects, toxicity, or adverse effects Physical signs and clinical symptoms relevant to the patient's drug therapy 3) Performs continuous evaluation of prescribed medications to assure optimal drug therapy. 4) Provides medication counseling to patients on discharge. 5) Extends medication therapy until next medical appointment when patients are out of medications (limited to non-controlled substances) per pharmacy "bridging" procedure. 6) Completes medication histories including patient interviews on admission when appropriate. 7) Serves as a drug information resource by providing up-to-date drug information to prescribers, other health care professionals, patients and caregivers. 8) Participates in patient care rounds, review charts, evaluates pertinent laboratory data, drug-drug and drug-nutrient interactions, monitors for adverse drug effects, and screens for allergies. 9) Performs medication reconciliation at all transitions of care, including updating the medication profile to reflect an accurate, active list of VA and non-VA medications. This may include adding non-VA medications or discontinuing duplicate medications or those the patient is not taking. 10) Assesses drug safety and efficacy, including evaluation of physical symptoms. 11) Reports adverse drug events (ADE), near misses, and medication errors in alignment with VA ADERS reporting program. 12) Participates in the medical center medication utilization evaluation (MUE) program and other QA programs that monitor drug safety and efficacy. 13) Recommends formulary alternatives and completes non-formulary consults as assigned. 14) Provides anticoagulation consultation including dosing and monitoring of anticoagulants, in accordance with local policy. 15) Participates in the facility Antibiotic Stewardship Program by reviewing antibiotics pending orders for appropriateness and making interventions as necessary. 16) The pharmacist is responsible for maintaining his / her professional competency by keeping abreast of current medical and pharmaceutical literature, new drugs and therapies, and applies this knowledge in his / her daily duties. b. Dispensing 1) Reviews all medication orders for appropriateness, drug selection, dosage, route of administration and the amount, prior to dispensing. 2) Ensures all medication orders are entered into the electronic patient medical record. 3) Fills all orders in a timely fashion; review of the patient's allergy history, drug-drug, drug-nutrient, drug laboratory and drug disease state interactions and assessment for clinical relevance should be performed and dealt with appropriately. 4) Reviews medical profiles and monitors for compliance or potential abuse; problems encountered shall be resolved. c. Education 1) Provides education to health care providers regarding medication use 2) Effectively instructs patients and family members in the appropriate use of medications and medical devices. Is able to adjust communication and tracking methods based on age and developmental considerations. Is able to accurately assess and document patient comprehension. Is able to refer patients to educational programs provided at the medical center by multidisciplinary teams. 3) Maintains basic knowledge of pharmaceutics, pharmacokinetics, pharmacodynamics, and pharmacotherapeutics in the area of practice 4) Assumes an active role in the overall pharmacy-training program consisting of students, externs, interns, residents, and professional and non-professional staff members. Conducts on-the-job training and provides guidance through designated programs 5) Keeps abreast of new developments in pharmacy practice and drug therapy by reading pharmacy and medical literature and participating in continuing education programs. Work Schedule: 8:00am-4:30pm, Monday through Friday Telework: Ad-hoc Available Virtual: This is not a virtual position. Functional Statement #: 63350F Relocation/Recruitment Incentives: Not Authorized

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