Maintains proficiency in clinical pharmacy programs and pharmacy operations as applicable to clinical specialty/role
Places priority on the delivery of patient-centered care
Works as an active member of multidisciplinary team and collaborates with healthcare providers
Establishes collaborative pharmacist-patient relationships
Proficiently maintains patient information and efficiently interprets patients’ health care needs including patient problem lists and prioritized pharmacist interventions
Complete accurate patient medication histories and reconcile discrepancies versus orders
Identifies high-risk patients and implements interventions to improve quality and safety
Makes appropriate evidence-based, patient-centered medication recommendations
Implements, evaluates, and redesigns pharmaceutical care plans based on patient progress and evolving goals for medication usage, including drug dosing, monitoring
Provides written documentation in the patient’s medical record when requested or directed
Participates in the management of medical emergencies, as applicable
Provides discharge medication review, reconciliation, and counseling as appropriate
Provides evidence-based medication education to physicians, nurses, and other professionals
Educates patients regarding safe and effective use of medications, possible medication side effects, and the role of prescribed medications in the overall therapeutic care plan
Maintains proficiency in hospital computer systems and medication ordering systems
Provides accurate, safe, timely, and appropriate medication therapy based on patient specific factors and needs
Assures timely medication dispensing and accurate medication availability on patient care areas
Interprets, evaluates, and accurately processes medication orders
Identifies, mitigates, prevents, and documents problems with medication orders or therapeutic regimens, including medication errors or adverse drug reactions
Completes critical patient monitoring and reviews patient profile/chart to identify, prevent, or mitigate drug related problems, improper drug or dose selection, adverse drug reactions, drug interactions, failure to receive drugs, untreated indications, medication use without an indication, and treatment failures
Communicate effectively and appropriately with healthcare providers and caregivers (physicians, nurses, etc.) and assure continuity of pharmaceutical care between shifts and among staff
Provides timely, comprehensive, and appropriate drug information to patients and healthcare providers
Actively participates in stewardship activities and restricted medication programs
Follows established standard work parameters and maintains standard work environments
Documents pharmacist interventions
