Happenstance Leads to Inspirational Gesture
Stead Family Children’s Hospital was built on a tiny piece of real estate between the main campus of University of Iowa Hospitals and Clinics (UIHC) and Kinnick Stadium, home to the University of Iowa Hawkeyes. Nary a place to build could be found at the top of that hill in Iowa City, so the building was placed adjacent to the football stadium. Twelve floors into its construction, some began to realize that there could be some amazing views of the Hawkeyes games from the building and subsequently designed a “press box” on the top floor so that patients could watch the games from inside the hospital.

Not long after opening the beautiful $360-million building, a social media post from western Iowa suggested that a kind gesture would be nice to build into the game from the field, and “the wave” was born. A Google search of “the Iowa wave” returns 139 million results. ESPN, Sports Illustrated, and most national news outlets have reported on this phenomenon, so when we found out that our Pharmacy Times®/Iowa Pharmacy Association participation in the Register’s Annual Great Bicycle Ride Across Iowa stopped in Iowa City this year on day 6, we could not resist stopping by and heading up in the elevator for a tour.

A Long History of Embedding Pharmacy in Pediatric Care
UIHC has a long and proud history of emphasizing pediatric care. In a rural area of the Midwest, Stead Family Children’s Hospital draws patients from across Iowa and nearby states who have complex circumstances and conditions. It was a natural marriage for Mark Sorenson, RPh, whose passion for infusing specially trained pharmacists into pediatric care dates back 29 years with UIHC.

It is “not just adult medicine in smaller doses,” but that “our kids have special doses and special needs,” said Sorenson, pharmacy pediatric clinical manager at UIHC.

These kids with special needs receiving specialized services warm the hearts of 70,000 fans on many Saturdays in the fall. They serve as a reminder for each fan watching a game that these little souls are fighting for their lives.

Serving Iowans Beyond the Walls of the Hospital
What was most striking about our visit was the camaraderie and sense of purpose that permeated everyone with whom we spoke. Health systems are prone to developing hubris and a sense of “not invented here” and a “we got this” mentality of business operations and practice. Yet, there seemed to be a genuine sense of care and collaboration, and very little pretense, beyond the company badges.

Mike Brownlee, PharmD, UIHC’s associate director and chief pharmacy officer, emphasizes organizational collaboration. “We have outreach clinics across the state and a close connection to community pharmacies and a community pharmacy network [that provides enhanced services and ensures warm handoffs],” he said. “Additionally, more than 600 students, residents, and fellows train specifically in pediatrics, and those young professionals take an appreciation for pediatric care with them as they migrate across the state and beyond, into the country.”

Getting Buy-in From Pediatricians
Each floor of the hospital has an office for the pharmacists, which is remarkable, because physicians often do not. “Proximity matters” Sorenson says. “I think the special nature of our patients and the level of integration in the teams [helps to engender trust and interdependence].”

The staff want the pharmacists on the floors and the pharmacy department projecting an aura of “ownership and accountability” for optimizing effective and safe medication use, so they are looked to as the experts.

Sorenson also emphasizes culture and team building. “Building a sense of team and relationships with other care team members … [and] … getting the right people [into the department] are keys to organizational success,” he said.

Some Humbling Advice to Pharmacist Students and Residents
Sorenson advises any pharmacists or pharmacists-to-be to consider pediatrics as a practice emphasis. “The great opportunity [with pediatrics] is … that you are going to have to use your head, because not all of the needed drug information is out there in pediatrics [to paint by numbers]. I always advise residents that when you tell [physicians and staff] what to do, they’ll do it. So, make sure you are right.”

Despite those humbling words, he has a passion for his work. “At this point in my career, I could probably step away and spend more time on my bikes, but it’s really rewarding work that keeps me here.”
 
Troy Trygstad, PharmD, PhD, MBA, is vice president of pharmacy programs for Community Care of North Carolina, which works collaboratively with more than 1800 medical practices to serve over 1.6 million Medicaid, Medicare, commercially insured, and uninsured patients. He received his PharmD and MBA degrees from Drake University in Des Moines, Iowa, and a PhD in pharmaceutical outcomes and policy from the University of North Carolina at Chapel Hill. He also serves on the board of directors for the American Pharmacists Association Foundation and the Pharmacy Quality Alliance.