SouthwestGeneralHospital Performance Review 2010

Job Title: Staff Pharmacist, Coumadin Clinic

Manager: Stacey VanZale-Zorska / Dave Ferris

SECTION 1: JOB PERFORMANCE

Job performance requirements that the associate can expect to be evaluated on for 2010

  • Complies with the current CHEST Guidelines for coumadin therapy and uses the coumadin clinic dosing algorithm and clinical judgment when necessary to adjust coumadin doses based on patient specific needs.
  • Demonstrates the ability to take vital signs such as blood pressure, heart rate, and also patient weight when appropriate.
  • Reviews each patient’s recent medical history, medications, diet, compliance, etc. as pertaining to coumadin usage.
  • Appropriately introduces new patients to coumadin by assuring that new patients view the coumadin video and explains the following points including but not limited to: purpose of coumadin usage in that specific patient, mechanism of action, international normalized ratio (INR), obtaining the INR, appropriate INR range for that specific patient, importance of close follow up, major drug interactions, major adverse effects, safety issues, pregnancy cautions (if applicable), diet, compliance, andvisit procedures.
  • Demonstrates ability to determine appropriate follow up appointment based on recent INR values.
  • Effectively counsels and communicates with patients and providers when necessary, and answers questions appropriately, and in a manner patients can understand.
  • Demonstrates ability to obtain blood specimen, utilize the CoaguChek monitor, and interpret INR results from the monitor.
  • Reviews patient specific INR goal to determine appropriate dosing of coumadin, assess whether dosage changes are necessary, and decide if vitamin K should be administered.
  • Communicates the INR value obtained to each patient, determines reasons for out of range INRs, and communicates dosage adjustments to each patient if necessary.
  • Demonstrates ability to effectively utilize CoagClinic software including entering new visit data, changing appointment times, viewing previous encounters, and printing patient handouts and progress notes for patient charts.
  • Communicate with providers regarding patient visits by documenting visit information in both the CoagClinic software program and the hospital computer system (Appbar).
  • Demonstrates the ability to use computer software to find patient information while in the hospital in order to see new coumadin patients before being discharged from the hospital.
  • Demonstrates the ability to conduct patient office visits, and follow up on phone calls and Home Health patient INRs in an efficient and timely manner in order to meet patient needs.

SECTION 3: GOALS

Organizational goals and the activity the associate should do to achieve these goals

Goal 1: Increase the percentage of patients in therapeutic INR range by 10 percent.

  • Employee Activity: Increase patient, family, and caregiver education on diet, drug interactions, alcohol use, and compliance with coumadin. Consider educational sessions for groups of patients with a certain disease state.

Goal 2:Achieve targeted patient satisfaction and customer service measurements.

  • Employee Activity:Review previous patient surveys to determine if goals have been met as well as distribute a new patient satisfaction survey that includes the recent changes made in the coumadin clinic. (Ask specifically about extension of hours in the coumadin clinic or if current hours are meeting patient needs.)

Goal 3:Continue to keep quality assurance measures for instrumentation in the coumadin clinic and for patient outcomes current.

  • Employee Activity:Assure that all quality assurance audits are up to date on the CoaguChek XS monitors and blood pressure equipment. Perform a chart audit on a group of coumadin clinic patients.

Goal 4:Determine if current coumadin clinic employees’educational needs are being met including but not limited to updates on treatment guidelines, newly approved medications, patient education techniques, etc.

  • Employee Activity:Review previous employee surveys and create a new survey to be distributed to coumadin clinic employees for feedback on current practices, comfort level regarding new medication therapies and patient counseling, suggestions for improvement, etc.

Possible additions per df:

Job Performance:

  • Be responsible for the day to day operation of the clinic and help as needed in filing and ordering supplies and patient education material.
  • Direct and supervise clinic personnel as needed and be available for conflict resolution.

Goals:

  • Contribute to educating our patients, families, students or staff through development of educational material, newsletters, website, blogs, inservices or other forms of communication.

MAG 12/1/09