Patient safety unifies us all

Cover Story

Pharmacy is one of the greatest professions in the world and it is full of opportunity. The roles for pharmacists that most people think of are the dispensing roles in the community and hospital pharmacies, not the clinical pharmacists’ roles in the hospital and ambulatory care clinics. But of course, pharmacists are doing much more than that, and in a lot more places. 


A brief look at the APhA Career Pathways Career Option Profiles show that there have been 25 major profiles identified. These include various roles in academia, community health centers, compounding pharmacies, government/federal pharmacy, home health care, managed care, nuclear pharmacy, office-based medication management, and the pharmaceutical industry, just to name a few. And although APhA is the umbrella organization that represents all pharmacists regardless of where they work and what they are doing, there are numerous pharmacy associations that cater to the specific needs of pharmacists. These include AACP, ASHP, ACCP, ASCP, NACDS, NCPA, AMCP, and many others.


With so many different roles for pharmacists and so many different associations for pharmacists to belong to, it is easy for pharmacists to become splintered and focus on what makes them different from other pharmacists, rather than what makes them the same as other pharmacists. Obviously, pharmacists all have a pharmacy degree in common, but even there, some would like to separate that into BSPharm, PharmD, and post-BS PharmD.


I am here to tell you that there is one thing that unifies all pharmacists—the role we play in patient safety. 


All pharmacists play a role


When you think about any of the profiles I mentioned earlier, you will realize that all of them play a role in patient safety.


In the community pharmacy area, pharmacists’ patient safety actions include making sure the patient is taking the correct medication, dose, and directions; checking for drug–drug and drug–disease interactions; and checking for allergies. Patient consultations help keep patients safe by making sure the patient understands what the medication is for, how to take it, and what to do if adverse effects occur. Pharmacist- provided immunizations and medication therapy management help to keep patients safe.


Pharmacists in the inpatient pharmacy have similar patient safety roles by checking IVs and patient dose carts or floor medication dispensing machines; making sure orders are correct; and many other roles. And of course, the clinical pharmacist specialists make sure patients are on the safest most effective medication dose. Whether it is providing pharmacokinetic consultations and medication recommendations; conducting a medication review and reconciliation; or providing discharge counseling to the patient, clinical pharmacists provide many services that keep patients safe.


Let’s not forget consultant pharmacists and long-term care pharmacists. Their role was specifically established to improve patient safety for patients in these institutions. Everything they do and all of the recommendations they make are tied to improving patient safety.


What about pharmacists in the pharmaceutical industry? They have a focus on patient safety as well. Whether it is developing new medications that are safe and effective to use, or serving as medical service liaisons that help prescribers learn how to appropriately prescribe new medication and generally provide better care for their patients, pharmacists in the pharmaceutical industry are also involved in patient safety. 


Even non-clinical pharmacists in academia have an impact in patient safety. They are responsible for training the next generation of practicing pharmacists to practice in a way that keeps patients safe. You show me a pharmacist, and I will show you someone who has some impact on patient safety. Patient safety unifies us all.


Educate patients 


Isn’t it great that patient safety is at the core of what pharmacists do? But unfortunately, we don’t do enough to educate the public and other health care providers about the important role we play in patient safety. Just think about how differently patients would interact with you in the community pharmacy if they knew that you were doing more behind the counter than just getting tablets from a bigger bottle, putting them in a smaller bottle, and slapping a label on it. 


What if they knew that for each prescription, the pharmacist checks to make sure the dose is correct, there are not any drug–drug or drug–disease interactions; and that the patient is not allergic to the medication. I know that patients would have a much better appreciation of the patient safety role that pharmacists play if they were reminded about each of these patient safety checks that pharmacists perform. 


How do I know patients’ views would change? Several years ago, I created a small checklist form that said, “During the filling of your prescription, a pharmacist completed the following Advanced Quality Check on your new prescription.” The list described the four quality checks I mentioned above and had a space next to each where the pharmacist could circle that there were no problems found or identify the 
problem that was identified. The pharmacist signed the form on the bottom. 


I provided some community pharmacy owners with the form and asked them to use it. I checked back in with them a couple months later and they said the change was amazing. So many of their patients told them that they had no idea that pharmacists were doing all of that “back there.” A pharmacist told me that one day a patient was waiting for her prescription. When the pharmacist said, “Let me get that prescription right out to you,” the patient replied, “No, no, you take your time. You are doing some important work back there.” This pharmacist realized that not only were his patients more appreciative of the work he did, his patients actually became more patient. 


My point is that pharmacists perform such an important role in keeping patients safe during their medication use, however, so few patients know about it.


Make the future a reality


Imagine how much more willing other health care providers, especially physicians, would be to work and collaborate with us if they understood that patient safety was at the core of what pharmacists had to offer. Make no mistake about it, physicians care about what happens to their patients and they take the responsibility for their patients very seriously. Although we can talk about all of the medication management services or disease state management services we provide, it really doesn’t connect with them as much as you saying that you also care about how well their patients are doing and that your services help to improve patient safety and optimize their patients’ medication therapy. 


If you ask a typical patient what do pharmacists do, they will tell you that pharmacists sell prescriptions. Wouldn’t it be much better if in the future their answer was, “They provide a number of different services that keep patients safe.” 


What can you do to make that future a reality?