Toolbox: Tips for establishing psychiatric pharmacy practice sites

Table 1. Potential barriers to pharmacy practice site development within an inpatient psychiatric setting and practical tips to overcome these barriers. Pearls Barriers Strategies Know the site Employers may quiz the potential employee during the interview process to test their desire to work for them. Be prepared. Review the history of the hospital; inquire about the patient population (e.g., number of beds, primary disease states treated). Once hired, rotate through each area that involves patient care – groups, court hearings, admissions, screenings, and discharges. Tour the places where patients are discharged (e.g., group homes and extended care facilities). Also, find out where your office will be (if one exists) and where you will be spending the majority of the time. Also, assess driving time between your site and where you will be living (or plan to live), and where the main academic campus is located (if applicable). Build relationships Personality differences are common, and some staff may prevent one from accomplishing practice goals. Take the time to get to know the pharmacists and technicians on staff in addition to the treatment team members. Inquire about their personal lives, create a birthday calendar, ask for help and thank them for their time. The simplest gesture may go a long way. Meet with directors (e.g., pharmacy, medical, nursing) and offer assistance. More importantly, develop a relationship with your attending psychiatrist. Some psychiatrists are welcoming to a clinical pharmacist, others are not. Explain the purpose of a psychiatric pharmacist (and pharmacy students) and list the goals expected to be accomplished. Being able to describe how your goals can improve patient care and decrease their workload can go a long way. Get involved It may be difficult to keep up with policy and procedure changes, especially if it is not a full-time practice site. Become an active participant in committees – Pharmacy & Therapeutics Committee, Nursing/Pharmacy, Clinical Guidelines, and various subcommittees as available. Request to be added to the email list for meeting notification – if one does not exist, create one. Educate staff Limited space and time with regards to providing education to your colleagues. A key role pharmacists may take is providing education to other healthcare professionals. Be creative. Integrate lectures into committee meetings; provide inservices during lunch; review difficult patient cases; start a journal club and encourage other professionals to attend and present. Utilize students Precepting pharmacy students may increase your workload. Space may be limited depending on your institution. Begin precepting one student at a time. Have APPE students lead educational inservices, attend committee meetings, and present on various topics (e.g., new drug update, journal club, and disease state topic discussions). Invite staff and other healthcare disciplines and students to join. Consider collaboration with pharmacists, physicians, nurses, psychologists, and faculty. Try a rotatingstudent schedule with multiple IPPE/APPE students if space is an issue. Focus on the patients Multiple obligations often cause one to shift attention elsewhere. Delegate assignments as appropriate. Create a pharmacist-led patient group (note: APPE students may assist with this). Continue to interact with patients (e.g., establish a goal to meet with at least two patients per day). APPE: advanced pharmacy practice experience; IPPE: introductory pharmacy practice experience