The Department of Pharmacy provides integrated, cost-effective pharmaceutical services to Stanford Hospital & Clinics (SHC). These patient-focused services include medication delivery, therapeutic recommendations, and promotion of optimal drug therapy.
To advance its mission, the department provides a supportive environment for professional training and development. The Department of Pharmacy participates in the American Society of Health-System Pharmacists (ASHP) Residency program. Three ASHP-accredited residency training programs are offered including a PGY-1 pharmacy practice residency and two specialty PGY-2 residencies in Critical Care and Oncology/Hematology. Stanford pharmacists also precept pharmacy students on clerkship rotations.
Inpatient Pharmacy Services
Inpatient pharmacy services to SHC are provided by clinical pharmacists 24 hours a day, 7 days a week. Inpatient distribution is done primarily through automated dispensing cabinets (Pyxis) on all nursing units which interface with the clinical information system. The clinical pharmacist must have reviewed the order before the nurse can obtain the dose for administration.
The Pharmacy Department provides services via eleven pharmacy satellites, including the Cancer Center and Stanford Medicine Outpatient Center (SMOC). Each acute care service has a pharmacist available on pager assigned to cover the area on a daily basis.
Clinical Pharmacists' Responsibilities
Clinical pharmacists are responsible for:
Managing warfarin therapy under a collaborative practice agreement (Warfarin per Pharmacy).
Reviewing patient medication regimens.
Screening new orders for potential problems such as drug allergies, drug/food interactions, intravenous (IV) incompatibilities, and the need for dose adjustments. Physicians are informed of potential problems and alternatives.
Round with many of the medical teams to provide drug information and collaboratively monitor patients' responses to their medications.
Actively involved in monitoring antibiotic therapy, total parenteral nutrition (TPN) therapy, IV therapy, and any medications that require additional laboratory monitoring such as warfarin and phenytoin.
Provide patient education in-house and at discharge upon request.
Electronic progress notes by pharmacists contain information regarding pharmacokinetic dosing recommendations, warfarin therapy, renal/hepatic dosing adjustments or other information related to a patient's medication therapy.
Many of our clinical pharmacists also precept pharmacy students and residents.
The hospital formulary promotes the objective evaluation, selection, and use of medications as a basis for rational drug therapy. The SHC drug formulary is a continually revised compilation of drugs that reflects the current clinical judgement of the medical staff as communicated through the Pharmacy and Therapeutics Committee of the Medical Board. The formulary makes available for use at SHC those drugs considered to be safe and effective while minimizing therapeutic duplication. The online formulary is accessible from any hospital workstation via LexiComp.
Ambulatory Care Services
In addition to inpatient services, pharmacists participate in the:
The Oral Anticoagulation Clinic (OAC) at SHC offers a comprehensive range of patient-focused pharmacy services. The goal of the clinic is to optimize patients' anticoagulation therapy with warfarin and to bridge patients with a low molecular weight heparin while transitioning to warfarin. Patients are carefully monitored and followed via on-site visits or through phone calls using an established anticoagulation protocol.
Pharmacy Resource Center (PRC)
The Pharmacy Resource Center (PRC) answers drug-related inquiries for health care professionals affiliated with SHC.
Center personnel research questions on a wide variety of topics including drug shortage management, drug selection, drug interactions, pharmacology, pharmacokinetics, adverse effects, teratogenicity, lactation, product availability, cost, and identification (domestic, foreign, and investigational).
The Pharmacy Resource Center maintains current drug-related references and utilizes computerized literature searches and World Wide Web information.
Investigational Drugs Service
The Stanford pharmacy also works in conjunction with physicians and researchers on investigational new drug trials in conformance with legal and accreditation requirements.
All investigational drugs are monitored and documented by the investigational drug pharmacist.