Clinical Pharmacy Specialist Infectious Diseases-Antimicrobial Stewardship
Position Summary: The pharmacist will work towards the system goal of improving antimicrobial utilization at the academic medical center institution and system level. Through collaborative work efforts, the person in this position will uphold processes including use of computer systems to evaluate provider order entry, microbiology interfacing, online medical records and alerts for best practice, quality and safety. This candidate will lead in the tracking and trending of antimicrobial resistance particularly as it relates to utilization. They will lead in the education of prescribers and other healthcare providers during live order review and feedback with the goal of maximizing antibiotic efficacy and cost- effectiveness. They will lead review of adverse drug events and provide solutions to avoid future events. They will lead antimicrobial Formulary optimization to help realize further cost benefits and improve congruence with evidence-based practice. They will lead junior
AMS-ID staff in clinical practice and program management.
Primary Duties and Responsibilities:
Practices pharmacy with a focus on antimicrobial management in accordance with the laws, rules and regulation of the Massachusetts Board of Registration in Pharmacy, Department of Public Health, the Food and Drug Administration, and the Drug Enforcement Administration and in accordance with established policies and procedures. Maintains licensure and credentials in accordance with the Board of Registration and submits proof annually.
Works with ID consult and primary teams on in person or telehealth initiatives (on-call service for Antimicrobial Stewardship or Infectious Diseases on a rotational basis). Assumes responsibility for daily team based activities of the Stewardship program including preprescriptive approval reviews, post prescriptive review and feedback, reviews clinical decision support alerts relative to drug duplication, bug-drug mismatches, therapeutic drug monitoring and intravenous to oral conversions.
Reviews patient specific data and identifies opportunities for intervention such as
- De-escalation based on microbiologic data
- Dosing optimization based on microbiologic data/patient specific pharmacokinetics
- Medication adjustments to avoid clinically significant drug interactions
Reviews and verifies anti-infective medication orders with consideration of the patient’s: diagnosis, weight/body surface area, age, allergies, organ function, laboratory indices, medication duplication, drug interactions, and other patient-specific factors. Clarifies orders deemed to be inappropriate, incomplete, or otherwise unclear with the prescriber in a timely manner. Documents pertinent information, ID-AMS interventions and/or discussion/s with the healthcare team to ensure continuity of care with other pharmacy and AMS staff. Communicates applicable information to subsequent shifts to ensure continuity of care.
Leads education and practice in therapeutic drug monitoring programs for competency and quality assurance. Prepares and delivers competency based education on the empiric approach to dosing and monitoring as well as collaborative practice agreements for Pharmacist based dosing and monitoring. Provides high level institutional summaries as well as feedback to local Managers to guide staff.
Responds to advanced therapeutic queries posed by physicians and other health care providers for consult services and curbsides on the AMS service through literature searches and reviews and summative outlines. Acts as a resource and reviewer for Junior ID-AMS staff. Maintains a library of resources for Stewardship/ID staff.
Reviews clinical staff education decks prepared by junior staff for
- physicians, nurses, and other health care professionals (minimum of one in-service per month)
- generalist pharmacists including competency based learning
- Assists the Antimicrobial Management Directors in the preparation of monthly/quarterly summaries of interventions to include:
- Quantification and qualification of interventions by: acceptance rate, cost avoidance, service and unit specific trends.
Trends and assigns cost avoidance/quality measures to interventions for institutional and service based entities
Serves as a mentor to junior ID AMS pharmacy staff in terms of advanced patient care scenarios, transitions of care, Formulary exceptions, research engagement. Orients new ID-ASP staff including learners (e.g. residents/interns)
Manages the Antibiotic Subcommittee to P&T Committee locally through the following
Finalizes the agenda and invitations/ information sharing for the local group. Works with the Directors for system engagement and feedback on System initiatives-agenda items
Reviews the preparation of anti-infective drug Formulary reviews
Edits and or adds to advanced literature searches and retrieval for a summative and evaluative review of basic science and clinical literature. Proofread and edits written summaries to meet system standards. Reviews and clarifies the recommendation for Formulary approval/denial based on safety and efficacy review.
Reviews and approves drug utilization reviews prepared by junior staff for any of the following categories:
- Drug based: drugs with high use, drugs associated with high costs, drugs with narrow safety margins.
- Pathogen based: pathogens with high frequency, pathogens associated with high costs.
- Resistance trending: identify potential relationships between utilization and local resistance.
Inventories and updates posted interdisciplinary guidelines relevant to antimicrobials and/or infectious diseases in preparation for regulatory visits or in response to practice changes-requests.
Heads up team based Quality Assurance and performance improvement metrics for inclusion in local and system dashboards
Acts as primary interface with Microbiology to prepare and validate susceptibility reports and antibiograms. current standard antimicrobial susceptibility reports based on site of infection and pathogen. Identifies and communicates on novel rapid testing platforms
Actively engages in continuous optimization of the EHR to support new and novel clinical decision support changes relative to antimicrobial utilization. Participates in gap analyses and idea generation, validation and provider experience surveys.
Ensures the antibiotic reviews and validation of antibiotic utilization submissions to the National Health Safety Network (NHSN) to meet regulatory compliance are running appropriately.
Works with Directors to prioritize the planning and implementation of programmatic short- and long-term goals. Assists in the coordination, implementation, administration and quality assessment of broader clinical pharmacy activities related to anti- infectives.
Serves as primary liaison with other department leads in Microbiology, Infection Control, Nursing, Pharmacy to facilitate education and change management.
Manages the solutions to operational problems related to daily reviews and tracking, communications, or data metrics.
Participates in the system continuum of care by communicating and cooperating with other health professional and outside health organizations
Formulates prioritization of annual research proposals and prepares/reviews presentations at local-state-national meetings.
Qualifications/Skills & Knowledge Requirements:
Required Qualifications:
- Bachelor's and Doctoral degree in Pharmacy (PharmD).
- License to practice as Massachusetts Pharmacist required.
- Pharmacy Residency PGY2 specific to Infectious Diseases training plus hospital experience
- Board Certification in Infectious Diseases Practice or completion within 1 year of hire
- Experience with computer systems required, including web-based applications and some Microsoft applications which including Outlook, Word, Excel, PowerPoint.
