NEWS-Line Publishing - Pharmacists -
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Published on: 1/1/1999
Last Visited: 3/11/2001
As Manager of Clinical Pharmacy Services at Ochsner Medical Institutions , headquartered in New Orleans , Debbie Hunt Simonson , Pharm.D. , says , Our goal in the ambulatory.setting is to have patients stay well , stay compliant , and stay out of the hospital.In the hospital , we are trying to provide them with the best quality practice and most cost-effective treatment to get the patient well as quickly as possible.
Our pharmacists function as part of a team , she emphasizes , and one of the biggest things that makes this place work , and work so well , is that everybody here works well together.The physicians here are very willing to listen and are open to different ways of doing things in order to ensure the best treatment for their patients..
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Simonson says that one of the reasons she has been with Ochsner for 17 years is that the leaders – administration , physician and nursing leaders – are open to suggestions for improving processes and providing better care.She says though sometimes it may take a long time to get done , it usually happens.One such example was getting the Micromedex ® on the mainframe.For a while , she says , they had Micromedex ® on the computers in pharmacy , in pediatrics , and in the emergency department , but the information was not easily available for every department.This database has such an array of drug information , though , like patient education , drug interactions , and other PDR information , that I believed that it ought to be available in every department.After three years , it was put on the mainframe , and now everybody here has access to it whenever they need it.
Right now , she continues , one thing we're looking at is how to determine the safest , most effective way to administer chemotherapy.Since 97 % of the chemotherapy is given through ambulatory practice in our clinics , we have to write our procedures so they will work for both ambulatory care and for more complex systems such as the hospital.This is a real challenge.
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Simonson explains the make-up of Ochsner.Ochsner Health Care consist of Ochsner Foundation Hospital , ( which was recently recognized by U.S. News and World Report as one of America's best hospitals ) .Ochsner Clinics consist of over 500 physicians in 64 specialties at 27 medical centers across New Orleans , Baton Rouge , and other parts of Louisiana.Ochsner also has an HMO , Ochsner Health Plan ( OHP ) , which is the largest in the state. It is jointly owned by the Foundation and the Clinics , she says , and offers both a commercial and a Medical Risk product , and currently has 230 , 000 covered members.
The Pharmacy Department provides the clinical pharmacy services for all arms of the hospital and the clinics , and Simonson oversees these clinical pharmacy services.I supervise day-to-day operational issues as needed , she says.I run patient care clinics , supervise and advise clinical pharmacy personnel … attend medical staff meetings , and work with physician groups on evaluation of drug therapy utilized within the hospital. In addition , Simonson evaluates pharmacy participation with ambulatory clinics.
She gives an example of this patient-benefitting/cost-loweri interventions offered by Ochsner's pharmacists.One opportunity we had was to start therapy earlier for Community Acquired pneumonia , ( CAP ) .First we got our team together , and developed a pathway – from prevention of CAP to treatment for a patient who is sick enough to be admitted.This included administration of vaccines in the hospital to at-risk patients before discharge , as well as administration of vaccines in all ambulatory clinics.We also ensured that all clinics had the recommended therapy in case they had a patient they felt needed to be admitted for CAP.These patients were given IM Rocephin ® at the clinic , and then either admitted directly to the hospital , or admitted through the ED [ Emergency Department ] .This can lessen the severity and length of the illness , of course.
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Additionally , Simonson says that her department has specific clinics to help people manage certain conditions.The pharmacy offers a lipid clinic , an anticoagulation clinic ( predominantly for cardiac patients ) , a hypertension clinic , and an H. pylori clinic.We also offer educational classes for our patients for anticoagulation and asthma.The pharmacy is also involved in geriatric services with our skilled nursing facility.We are also developing a compliance clinic for patients discharged from the hospital , especially those who are switched from I.V. to oral therapy and discharged..
The pharmacy has a program designed to increase patient compliance in taking medications at home.
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Simonson says she knew early on that she wanted to be a pharmacist.I'm one of those people who's very focused , and I made my decision in high school to become a pharmacist.I considered med tech , M.D. , and pharmacist as careers , she says , and decided to look at all three.First , I worked with a med teach for about a week and decided very quickly , this was not for me. Next , I went to a hospital and asked if I could round with a doctor there for a week.I really enjoyed the field , but it wasn't for me either.Next , I got a summer job at pharmacy and loved it!.
The greatest challenge that I face today as a pharmacist , she says , is to be able to convince managed care groups , insurance groups , government regulatory groups and administrators , about the value of pharmacists in large networked healthcare systems.Physicians and patients are already satisfied with the services we provide as pharmacists , and our outcomes studies and satisfaction surveys show that they are cost-effective and do demonstrate an increased quality of care.
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Simonson , who is a Pharm.D. , comments that the pharmacist's role has changed in regard to following procedures exactly as they are written.Pharmacists now have to look at each patient individually and see what is best for that patient and how they can provide the best care within the policies and procedures of the institution.We have to think ‘out of the box' and take care of the individual patient.In the past , pharmacists did not have to do this – they followed procedures ; but not all patients fit into the set procedures.
Pharmacists still have to follow the laws and standards of practice that the American Society of Hospital Pharmacists ( ASHP ) and other groups provide for us , but they also have to be flexible.For example , if the pharmacist cannot do the recommended patient education in the hospital because the patient was discharged early , then they have to follow up with the patient through ambulatory services the next day.
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Debbie Hunt Simonson earned her bachelor of Science in Pharmacy from Auburn University , Auburn , Alabama in 1980.She earned her Doctorate of Pharmacy from Xavier University , New Orleans , Louisiana , in 1998.
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