Clinical Pharmacist
Current- Prepare patients for hospital discharge. This requires collaboration with discharging physician regarding appropriateness of discharge medication regimen, electronically sending prescriptions, and counseling patients on discharge.- Perform extensive medication reconciliation requiring verification of home medications, evaluating appropriateness of medication changes made at admitting facility, and making recommendations to physicians regarding improvement of medication regimens based on guideline recommendations. - Compile monthly reports of transfer errors made by admitting facilities and collaborate with patient safety teams from admitting hospitals to idenify areas for improvement on discharge medication lists.