Pharmacists are often thought of simply as the people who fill prescriptions at local pharmacies, but at Utah Valley Regional Medical Center pharmacists are playing a bigger role, including working in person with a patient's medical team to make sure the right medications are being used.
Every floor of the hospital is assigned to decentralized pharmacists, who work specifically with the doctors, nurses and patients on that floor.
"We will do consults with doctors. Rounding with doctors is something we are doing here actively," said Penny Fugal, a pharmacist on the cardiac intensive care unit. "Our job is really to help the doctors and the nurses and help other people on the health care teams by rounding with them and reviewing medication."
The pharmacists do more than just review the medications patients have already been prescribed. They will suggest new or alternative medications that will be more effective for patients and often are in charge of making sure patients are taking the right doses of medications and bringing up any potentially harmful drug interactions.
"I think what the pharmacists do is bring additional expertise, another fail safe to make sure we are aware of drug interactions and dosing issues that come up in certain situations," said Dr. Tracy Hill, medical director of adult critical care at Utah Valley Regional. "It improves care, creates better outcomes for patients and improves safety."
The concept of decentralized pharmacy has been happening in the ICUs at Utah Valley since the 1980s but has only become widespread in the last five years.
"A lot of patients don't know that there are pharmacists on the floor taking care of them and their medication needs," Director of Pharmacy Robert Nahoopii said. "Most of them think that there is a pharmacy somewhere and they are all huddled in the corner producing medications and shipping it off to floors."
Fugal has worked as both a decentralized and centralized pharmacist and says she enjoys working on the floors and interacting with patients and doctors.
"I find working the floors rewarding. I love that I get to be part of that team, I get to be there at the decision-making process, I get to be there face to face with the patient, I get to be face to face with families," Fugal said. "I love working with the nurses and doctors."
Pharmacists working on the floor benefit patients and their families in a number of ways, including having someone to explain new medications when doctors may not always have the time and being there to change medications if a patient's doctor is in surgery or with another patient.
"The pharmacist is always here so we can adjust levels, change the dose and make any recommendations immediately," Nahoopii said. "That means patient care is optimized and more efficient because it is one less thing physicians have to worry about. In a way pharmacists become a physician extender."
As a doctor Hill says having pharmacists on the floor benefits everyone involved.
"I have done it both ways and it is clearly a huge advantage to have them there in terms of patient safety," Hill said. "[Decentralizing pharmacists] is one of the best changes in my long career. They are highly educated individuals and an enormous value to the system."
Utah Valley Regional is creating a program that would assign a pharmacist to monitor medications after patients leave the hospital. He says they hope to have that program in place by the beginning of the year.