EVOLVING ROLES LEAD TO NEW OPPORTUNITIES
Dr. Wordell is the assistant director of Medication Use Policy, Research and Clinical Services, Department of Pharmacy, at Thomas Jefferson University Hospital.
Cindy J.Wordell, BS, PharmD
A career as a health-systempharmacist today traces its roots to the 1960sand the efforts of early leaders, such as DonaldFrancke at the University of Michiganand Paul Parker at the University of Kentucky.Their vision was to have pharmacistsfocus on the patient and optimizing drugtherapy, and not just the drug itself as theproduct. Throughout the 1970s and 1980s,the role of health-system pharmacistsexpanded to include dosing of medications,education of patients and health careproviders, and control of drug costs.
Three recent events have significantly influencedthe opportunities available tohealth-system pharmacists and facilitatedachieving the vision of the early pioneers fora patient-focused pharmacy practice. Thefirst event was the publication in 2000 of theInstitute of Medicine (IOM) report, To Err isHuman, which emphasized the importanceof an interdisciplinary team approach toimproving medication safety. The secondevent was the publication of the Joint Commission'sNational Patient Safety Goals(NPSGs) in 2002 with the objective ofimproving patient safety in the health caresystem. As in the IOM report, an interdisciplinaryprocess is encouraged. The NPSGsare revised annually, with those achievedgoals removed from the list and new onesadded. The NPSGs are frequently directed atdrug therapy and often lead to new opportunitiesfor pharmacists. The third event hasbeen the growth in information technology,including automated dispensing machines,electronic medical records, and robotics.This has enabled the health-system pharmacistto move from the pharmacy to the patientbedside. These 3 events have resulted inmany and varied opportunities for pharmacists.Health-system pharmacists can participatein drug therapy selection, improvemedication safety, facilitate application ofautomation and informatics, and educatepatients and other members of the healthcare team.