Pharmacists Steve Lee, RPh, and Meredith Simons, PharmD, serve patients at University Pharmacy inside the lobby of University Hospital. Renovated in May 2014, the new space is more than three times larger than the previous location.
Pharmacy's expanding role
The role of a pharmacist has changed dramatically since the profession’s beginnings centuries ago. Just fifty years ago, pharmacists solely dispensed medication — they were not to discuss medications with patients or even disclose what the medications were for. In today’s rapidly evolving health care environment, pharmacists are a key player in the health care team. From managing the acutely ill to everyday ailments, pharmacists are involved in every facet of the patient experience. “The role of the pharmacist is more than just filling prescriptions and verifying medication orders,” said Julia Chisholm, PharmD, manager of outpatient pharmacies at University of Missouri Health Care.
Julia Chisholm, PharmD, manager of outpatient pharmacies at MU Health Care, helps an employee find a medication in the remodeled University Pharmacy at University Hospital.
"While many aspects of our work have changed, such as the incorporation of automated technology, we’re placing an increased emphasis on interacting with and educating patients in all aspects of their health care. Quality interactions and personalized service are keys to improved outcomes through medication adherence."
In addition to being a place to purchase necessities, such as over-the-counter items and diapers, pharmacies are a place patients seek health care solutions, Chisholm said. Pharmacies today provide expanded health care services and medication information through many points of contact. Patients and providers not only ask questions about medications, but also about health-related issues.
MU Health Care operates three hospital pharmacies and nine outpatient pharmacies. MU Health Care offers the largest chain of pharmacy locations in Columbia, including the newly remodeled outpatient pharmacy in the first-floor lobby of University Hospital. After several years of planning and conceptual designs, the new space opened in May. At more than 2,700-square-feet, University Pharmacy is more than three times larger than the previous location and is the largest of MU Health Care’s retail pharmacies. This increased size allows for an expanded selection of over-the-counter items and clinical pharmacy service offerings. The pharmacy also includes a private counseling room that allows pharmacists to provide education and give immunizations.
“This gives us a private spot to talk with patients who may want more information or who may have concerns about their medications,” said Joe Cameron, PharmD, critical care and infectious diseases pharmacist and interim pharmacy services manager for MU Health Care. “It’s another step to make sure patients understand their treatment and are getting the proper care. Our pharmacists have an extensive knowledge base, and we can provide patients and health care providers the right medication to help treat the problem or illness.”
Behind the counter, the pharmacy team now has more storage, a larger workflow area and specialized equipment. A medication carousel optimizes the new space and holds more medication per square foot, and a nearby automated counting device, Script Pro, holds up to 200 medications. The machine counts and dispenses pills, freeing staff to work directly with patients.
“The new pharmacy setup gives us a chance to have more one-on-one interaction with our patients,” Chisholm said. “We’re always actively exploring new ways improve the patient experience at MU Health Care.”
The patient experience
Over the past year, MU Health Care pharmacies have launched a new program for patients who are discharged from University Hospital, MU Women’s and Children’s Hospital or the Missouri Orthopaedic Institute. Commonly referred to as a first-dose or concierge service, the MizRx2U bedside medication delivery program provides discharge medications and education to patients before they leave the hospital. Patients can receive their prescriptions without setting foot outside their rooms, saving time and offering another level of convenience. The goals of the program are to improve patient satisfaction, transitions of care and overall patient outcomes.
Amanda Sobczak, pharmacy technician, delivers a prescription to Jamie Cole, a new mother from Clark, Missouri, at MU Women’s and Children’s Hospital. MizRx2u offers bedside delivery of prescriptions to patients before they leave the hospital.
“Bedside delivery is the biggest initiative our retail pharmacy services have undertaken throughout MU Health Care,” Chisholm said. “The program helps make sure that patients are getting their prescriptions filled and makes the transition from hospital to home easier. We know that getting a prescription can sometimes feel like a lengthy process, but we’re taking steps to improve that process for our patients.”
If a patient opts for bedside delivery, a team member from the hospital sends the enrollment form, along with the prescriptions, to the pharmacy for processing, or patients can also choose bedside delivery when they are admitted. The pharmacy will compile the necessary information and process the prescription. Once the prescriptions are filled and verified, a pharmacist then calls the patient’s room to explain instructions and answer any questions the patient may have.
“The phone call is the key step in the process,” Chisholm said.
This allows the pharmacist to discuss potential side effects of the medication and to ensure the order is filled completely. Based on the patient’s preference, a pharmacist or pharmacy technician will complete the delivery to bedside. The entire process is completed within 60 minutes. Prescriptions also can be fast-tracked for any patients preferring to pick up medications themselves.
Before implementing the bedside service, Chisholm and her colleagues studied data from other hospitals that offer similar delivery services. They found that this interaction with patients is a contributing factor to increased patient satisfaction and decreased re-admission rates. Because patients are receiving the medication directly and are more knowledgeable about the drugs after being counseled on how to take them appropriately, they know what to look for or what possible side effects to consider.
“Last year, we piloted the program at the Missouri Orthopaedic Institute and pharmacy, and on the post-partum unit at Women’s and Children’s Hospital and the Keene Street Pharmacy,” Chisholm said. “We had phenomenal results. Many new parents don’t want to leave their rooms or make one more stop on their way home, especially with a new baby. Bringing the prescriptions to their rooms is convenient and easy.”
In addition to bedside delivery, MU Health Care’s outpatient pharmacies offer 90-day prescription fills and a mail-out option, which has become a popular choice for patients who live in rural areas and do not want to drive long distances to get their medications, Chisholm said.
“Our goal is to be accessible to our patients and to offer the best customer service,” Chisholm said. “We’re striving to be more than just a pharmacy. We want to build relationships and follow through with our patients, no matter if they use us on a regular basis or if they only have prescriptions written when they are ill.”
The pharmacies also offer a free delivery option for University of Missouri employees. Medications can be delivered to nearly every building on campus and some off campus locations, including Mizzou North and Quarterdeck.
The health care team
MU Health Care’s Pharmacy Services department has experienced several changes since 2012. Chief among the changes is the relocation of University Hospital’s inpatient pharmacy to the ground floor of the hospital and the transition to an automated medication delivery system.
“The automation improves patient safety by ensuring the patient is receiving the correct medication,” Cameron said. “Medication safety is a top priority, and timely delivery of the most effective medication is the main goal of this system. Without that, our patients don’t get better.”
But getting the right medication to the right patient is not the pharmacists’ only focus. A hospital pharmacist not only dispenses medication, but is part of a health care team that rounds on patients each day and makes recommendations on what medication would best help each individual inpatient.
“The medication therapy our hospital pharmacists provide is crucial and vital not only to patient care, but also to the education of resident physicians and attending physicians,” Cameron said.
On the horizon
With the completion of the clinic at South Providence Medical Park in 2015, the pharmacy at the University Physicians-Green Meadows clinic will relocate, offering more retail space, a counseling and immunization room and additional storage, work area spaces and a drive-through lane. Additionally, the South Providence pharmacy will offer expanded hours, including weekends and holidays.