Clinical Pharmacy Specialist HemeOnc

Responsibilities:
Outpatient care:
1. The hematology/oncology/SCT pharmacist will:
a. Be available as needed during the evaluation phase if any multidisciplinary team member feels a consult is needed by the hematology/oncology pharmacist.
b. Participate in development of patient education materials with multidisciplinary team members in preparing patients for SCT.
c. Be available on a consultative basis to the outpatient SCT clinic on patients with immunosuppression problems identified by any multidisciplinary transplant team member.

Inpatient Acute Care:
1. The hematology, oncology, gyne/onc and SCT pharmacists:
a. Attends interdisciplinary rounds for malignant hematology, medical oncology, gynecologic oncology and SCT daily to assist the respective team with the design, implementation and monitoring of medication regimens.
b. Reviews drug therapy to ensure appropriate use, dose, dosage form, regimen, route, therapeutic duplication, drug allergies, drug interactions and cost-effective therapy.
c. Reconciles home medications for admitted patients.
d. Discusses medication order clarifications with the prescriber/healthcare team and document any changes in patient and pharmacy records to inform others of medication order changes.
e. Provides individual patient/family counseling on medication regimens, adherence to medication regimens and adverse effects of medication regimens to patients/caregivers prior to discharge of allogeneic SCT patients and other patients deemed appropriate and document in the electronic medical record.
f. Provides pharmacokinetic consultations as required. Kinetic notes are written for every new start of vancomycin or an aminoglycoside and for dose modifications.
g. Prevents, detects monitors, documents and reports adverse drug reactions and medication errors.
h. Reviews chemotherapy orders for hematology, oncology, gyne/onc, and SCT patients receiving chemotherapy inpatient.
i. Available to nursing staff for questions on medication orders.
j. Order verification/in-basket messages for assigned units.
k. PM staffing required, frequency based on departmental need.
l. Changing medications from IV to PO as appropriate.
m. Assist with facilitating chemotherapy desensitizations in the MICU.

Discharge Planning (Inpatient Acute Care):
1. The hematology/oncology/SCT pharmacist will:
a. Participate in discharge planning and discuss relevant changes to the home medication list prior to discharge with the team and/or the patient as required.
b. Help facilitate discharge planning for smooth transition to outpatient pharmacies or alternate site of care.
c. Assist in assessing insurance coverage and assist in prior authorization for medications (when necessary) in advance of discharge.

Other responsibilities (Hematology/Oncology/SCT):
1. The hematology/oncology/SCT pharmacist will:
a. Act as the pharmacy liaison to the Cancer Center.
b. Coordinate pharmacy participation in hematology/oncology, SCT and gynecology/oncology-related committees.
c. Actively participate in multidisciplinary hematology service meetings.
d. Actively participate in multidisciplinary SCT service meetings.
e. Provide updates in therapeutics to the hematology, oncology programs as needed via memos, presentations and one on one communications.
f. Provide education to the interdisciplinary round team members on relevant medication topics as needed (e.g. neutropenic fever).
g. Participate in quality improvement initiatives for the hematology, medical oncology, gynecologic oncology and SCT programs.
h. Actively participate in outcomes-based research for the hematology, medical oncology, gynecologic oncology and SCT programs
i. Participate in coverage of Heme/Onc Clinical Pharmacist pager.

Other responsibilities (Department of Pharmacy):
1. The hematology/oncology pharmacist will:
a. Provide updates in transplant therapeutics to the Department of Pharmacy as needed via memos, presentations and one on one communications.
b. Assist with chemotherapy monographs, Epic builds, guidelines for use for newly approved chemotherapy agents.
c. Precept Introductory to Pharmacy Practice (IPPE) students, Advanced Pharmacy Practice Experience (APPE) students, Pharmacy Practice (PGY1) Residents and Specialty (PGY2) Residents on rotation in the hematology/oncology/SCT specialty area.
d. Be available for drug distribution and order verification support as needed.
e. Work with the pharmacy operations manager regarding chemotherapy workflow issues.
f. Work with pharmacy informatics to improve chemotherapy workflow and safety.
g. Assist in the review of pharmacy policies impacting chemotherapy processes.
h. Participate in multidisciplinary Clinical Resource Management meetings for areas of specialty.

Promote and demonstrate rational, cost-effective drug therapy:
1. The hematology/oncology/SCT pharmacist will:
a. Develop, implement and monitor hematology/oncology/SCT-related clinical protocols and guidelines.
b. Identify and implement drug therapy where positive pharmacoeconomic impact could be achieved. The ultimate goal is to develop and assure cost-effective clinical pathways.
c. Present relevant drug therapies at the hospital Pharmacy and Therapeutics Committee and will serve on the Chemotherapy Pharmacy and Therapeutics Subcommittee.
d. Document clinical interventions and cost-avoidance as part of the pharmacy departmental documentation (I-Vent) program.
e. Monitor the use of expensive medications to assure use consistent with approved criteria.
f. Anticipate changes in drug therapy and report the potential impact it will represent to the overall hospital and drug budget.

Universal Pharmacist Responsibilities:
1. Order Approval
2. Staffing (weekday, weekend, and holiday)
3. Aseptic technique
4. Document I-vents
5. Distribution systems (Pyxis, carousels, etc.)
6. Anticoagulation dosing/monitoring
7. Antibiotic dosing
8. Pharmacokinetics
9. Narcotics
10. Code blue pager coverage
11. Crash cart checking

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