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Top 10 Tips for Establishing New Pharmacy Services

by Rebecca Castner, PharmD, Chicago State University College of Pharmacy; Reviewed by Shubha Bhat, PharmD, BCACP, UIC College of Pharmacy

As the healthcare landscape continues to change, pharmacists today look for clinical opportunities to expand services, lower healthcare costs, and improve patient care. These opportunities often require establishment of not only patient relationships, but provider relationships as well. This fact is one of the many I have learned as I currently create clinical services in a specialized community medical home. Previously I worked to establish services in an internal medicine clinic within an academic medical center. However, despite the major differences in practice site and patient population, I have noticed many similarities in the process of establishing pharmacy services at both locations. While I could write many pages about this subject, I have whittled down what I believe to be are the top 10 practical points to keep in mind when setting up clinical services. While these suggestions are geared toward establishing new services, they can also be applied to current clinical practices in order to enhance and/or expand the existing practice site.

1.   Create an open dialogue.
Change is difficult and uncertainty can be stressful for even the most pharmacy-friendly medical practitioners (including other pharmacists at your site). Let the site know that you want to develop WITH them and that you plan to address their concerns as well as make their needs your priority.
2.   Go to meetings.
Whenever possible, attend provider meetings to stay up-to-date on the site’s needs, and attend support staff meetings as well. Remember that providers may have not worked with a clinical pharmacist before and may lack awareness regarding the services and skills a clinical pharmacist can offer. Even something we consider to be an obvious niche, such as adherence counseling, may not be known by other professions. This is also a good way to get to know the providers and staff, and establish relationships. In the beginning, it can be easy for the providers to forget you if they do not see you regularly.
3.   Be open to questions.
Even if you are hired to fill a very specific role, it is ideal to make yourself available as a general drug information resource in addition to your specific duties. If you appear knowledgeable about a variety of drugs and disease states, this fosters trust with the providers in your clinic. Also, always remember to follow up promptly if you have to get back to a provider later regarding their question.
4.   Make (tactful) suggestions.
As the new provider in clinic, it can be daunting to make suggestions to other providers, especially if they have been practicing at that site for a long time. Keep in mind that you would not have been brought on board if your expertise could not improve the practice. Making suggestions is important, and it shows that you are engaged. However, be sure to make all suggestions with tact, and with a complete understanding of the site’s policies and procedures. Be aware of how you phrase your suggestions – asking providers if they have considered implementing something instead of making a statement of how things “should be” will likely elicit a much better response.
5.   Be persistent – but also have patience.
If you have an idea accepted by the providers, be sure to take initiative and follow up on it regularly to move things forward. However, keep in mind that things take time to develop, especially in the medical setting where legalities and patient safety are paramount in every step of a new service or within every change to protocol.
6.   A little preparation goes a long way.
When presenting an idea, thoroughly do your research, and be prepared to have a succinct and cohesive “elevator speech” ready on demand to justify it. Showing how other clinics have implemented similar clinical pharmacy services successfully (especially if there is a cost-saving aspect) will go a long way in having services implemented at your site.
7.   Utilize your network.
Even if you are the only pharmacist at your site, you are not alone! Utilize the expertise of colleagues who have accomplished similar things as you aspire to do. Being prepared for roadblocks (and learning how others have effectively handled them) is invaluable information. ICHP is a wonderful resource to look to for support in these endeavors.
8.   Be flexible and reliable.
Try to set a schedule for yourself so other practitioners know when they can expect you to be available. However, be aware that when starting new services, you may need to be available outside of these times for meetings, and be open to the fact that the hours you initially thought were best might not be in practice. If this is the case, discuss with your supervisor and adjust your hours as best fits the needs of the clinic when possible. Keep the team informed of when you have days off or when you are in a meeting, so they are not searching for a resource that isn’t there.
9.   Communication is key.
Communicate what you can do for the clinic, but also do not be afraid to let others know what you are NOT there for. Remember, many people’s perception of a clinical pharmacist is the individual wearing a white coat standing behind the counter. Do not take offense if asked to perform roles that are not of your purview, and explain politely that certain roles are not the same for a clinical pharmacist as for pharmacists in other settings. 
10.   Remember everyone was the new kid once.
Smile and introduce yourself! It may take a little while for the team to understand your role, but everyone always loves having a pharmacist once they are established.

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