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Pharmacy-based health clinics, run by nurse practitioners and physician assistants, seem to be popping up everywhere across the country. According to USA Today, approximately 150 retail pharmacy-based health clinics are now in place nationwide.1 Peter Miller, chief executive officer of Take Care Health Systems, estimates that thousands of new clinics could be opened over the next 5 years.2
Indeed, retail pharmacy chains and mass merchandisers are continuing to announce new or expanding walk-in clinic services. In the past year, CVS has acquired MinuteClinic, the largest provider of retail-based health clinics in the United States. Walgreens has partnered with Take Care Health Systems, RediClinic, and Pinnacle EasyCare to open Health Corner Clinics. Target and Medcor are operating Target Clinics in select locations, and WalMart is working with RediClinic. These clinics not only give patients easy access to health care services, but present a great opportunity for pharmacists to work closely with clinic staff to prevent medication errors.
Do you have a clinic opening or under consideration for your store? If so, make sure that you meet with all the clinic practitioners as well as their office staff. During the meeting, consider discussing and carrying out the following safe practice recommendations. (Note that the same steps should be considered for office practices from which you frequently receive prescriptions.)
?Introduce the clinic personnel to all the staff in the pharmacy. Take them for a tour, and show them how prescription intake, preparation, and dispensing are performed.
?If you have prescription-scanning capabilities, show them what a scanned prescription looks like in your system. Demonstrate how different prescription blanks scan, and point out which ones to avoid using so as not to distort the actual order (eg, blanks with watermarks designed to discourage diversion). Help them design prescription blanks that include indication icons.
?Encourage them to use an electronic prescribing system. Work with them and their vendor to ensure that information is printed, faxed, or sent electronically in a clear format.
?Ask them to include the indication for use whenever they write, send electronically, or call in a prescription
?Ask the prescriber to print his or her name on the prescription or circle it if it is preprinted on the prescription blank. Patients may not remember hearing the provider's name?which makes it difficult for a pharmacist to communicate directly with the prescriber when there is an issue with the prescribed therapy.
?Review with prescribers the various informational tools, patient profiles, and data sets available through your pharmacy system and pharmacy benefit manager connectivity
?Describe how drug-utilization review and prior-authorization processes take place
?Recommend drug information reference materials that they should have available in their clinic or office
?Encourage them to contact one of your pharmacists for any druginformation questions
?Let them know that you will dispense appropriate measuring devices every time they order a liquid medication. Make sure that they know the risks of using or recommending parenteral syringes for oral liquid use.
?Share with them safety tools (eg, FDA-Institute for Safe Medication Practices Abbreviations Campaign Toolkit) and error-prevention strategies
?Let them know that safety is your priority when filling prescriptions, and invite them to be part of your safety team
Dr. Gaunt is a medication safety analyst and the editor of ISMP Medication Safety Alert! Community/Ambulatory Care Edition.
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1. Schmit J. Could walk-in retail clinics help slow rising health costs? USA Today. August 14, 2006. Available at: http://www.usatoday.com/money/industries/health/2006-08-24-walk-in-clinic-usat_x.htm. Accessed January 12, 2007.
2. ABC News. Walk-in Medical Clinics Take Retailers by Storm: Patients Like Alternative's Convenience, Short Wait. October 19, 2006. Available at: http://abcnews.go.com/WNT/PrescriptionForChange/story?id=2586216&page=1. Accessed January 12, 2007.