Fred J Boyd 2007 Award - jppr

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GlaxoSmithKline Medal of Merit 2007—Rosemary Burke The GlaxoSmithKline Medal of Merit is awarded annually for outstanding service to Australian hospital pharmacy. For her significant contributions to hospital pharmacy and ongoing efforts to improve safety for patients, Rosemary Burke, Director of Pharmacy, Concord Hospital is the recipient of the GlaxoSmithKline Medal of Merit 2007. Rosemary has made an outstanding contribution to the practice of hospital pharmacy over many years. She has been active in education and training of pharmacists and graduates, in the workplace and the wider health community. Since 1997, Rosemary has actively contributed to the Pharmacy Board of NSW, not only participating in graduate review processes but also contributing a hospital pharmacy perspective to course structure revision and site evaluations for educational facilities. Rosemary has been a member of SHPA since 1988. Between 1996 and 2001, she was a member of the NSW Branch Committee and was Chair from 1997. Rosemary continues to provide advice to the Branch Committee and has been a member of the organising committees for the 4th SHPA Biennial Clinical Conference and the 28th Federal Conference. Since 2002, she has shared her knowledge and experience by leading the SHPA Medication Safety Committee of Specialty Practice. In her workplace she has demonstrated leadership by ensuring the appointment of an Area-Wide Quality Use of Medicines Pharmacist to coordinate action across a number of hospital facilities. She has also attracted some significant grants to progress multidisciplinary medication safety initiatives in her local environment led by hospital pharmacists. Since 1994, Rosemary has been a member of the NSW TAG and a member of the NSW TAG Management Committee since 2002. Rosemary has been a member of the NSW TAG Safer Medicines Group since its inception in 2004 and has participated in a number of key working groups. In 2005, she was a member of the NSW TAG Australian Advisory Panel for adaptation of the ISMP Medication Safety Self Assessment tools for use in Australian hospitals. Rosemary has also been a member of the Project Steering Committee for the NSW TAG Performance Indicator and Medication Safety Project which, during 2006 and 2007, has developed Indicators for Quality Use of Medicines in Australian hospitals. It is an honour and a privilege to accept the Fred J Boyd Award. I feel extremely humble to be among the many distinguished recipients of this and the Glaxo Medal of Merit and Clinical Pharmacy Awards. I recognise that there are many more deserving members who have given outstanding service to our profession and the Society in particular, and I hope your work and commitment will be duly recognised. It is a very proud moment for me. I wish to thank the members of the ACT Branch, in particular the Chairman, Andrew Matthews, who nominated me, and then with great determination and trickery, convinced me to accept the nomination. Sue Alexander, BPharm, Pharmacist, The Canberra Hospital, Garran, Australian Capital Territory Address for correspondence: Sue Alexander, Pharmacy Department, The Canberra Hospital, Garran ACT 2605, Australia E-mail: Susan.Alexander@act.gov.au Fred J Boyd Award Oration Susan Alexander Rosemary Burke recipient of the GlaxoSmithKline Medal of Merit 2007 Rosemary is currently collaborating with investigators to evaluate the impact of electronic medication management systems on work practices, pharmacy activities, medication errors and patient safety. Rosemary has been instrumental in engaging decision-makers in hospital and government to recognise the role of hospital pharmacists in realising the safety outcomes that electronic systems are expected to facilitate. The GlaxoSmithKline Medal of Merit Award for 2007 is awarded in recognition of Rosemary’s continuing achievements in supporting the development of hospital pharmacy. I would also like to thank the pharmacy staff at The Canberra Hospital and Neil Keen, the new Director of Pharmacy. He is one of our Federal Councillors and the Chairman of the SHPA Division of Education. I have had the luxury and support of Neil and the hospital to phase my retirement from The Canberra Hospital over the past year. While ostensibly I have been there to handover, and provide support and advice to Neil and the staff, I have also been able to indulge in my favourite job of working in the dispensary and directly looking after patients. It has probably been frustrating for the rest of the staff though. I often hear, ‘Ask Sue, this phone’s for Sue, where’s Sue?’ and there I am at the pharmacy counter, talking to a patient, planning to meet up in Paris with one of our renal transplant patients who has been posted to the Embassy there, or talking to Richard (who prefers to be called Rachael), about his CD4 count and the latest movies. Journal of Pharmacy Practice and Research Volume 37, No. 4, 2007 315
Last week (coincidentally at the same time) two adult CF patients who have had lung transplants presented their S100 prescriptions to me. I have known both of them since they were children in the 1970s, when I worked in the CF clinic at Royal Canberra Hospital as a paediatric pharmacist. I was thrilled to be able to take the time to talk to them both again. Needless to say, every day, I find it a thrill to work in the dispensary, not only because of contact with the patients, but because of being ‘hands-on’ again, working with a wonderful team of technicians and pharmacists and being able to mentor the graduates and students. Anyway, I have digressed from what I wanted to talk about today, which is not about succession planning (although I can highly recommend it), but about the changes I have experienced in the past 30 years of my career, and how SHPA has been there to guide and support me. Neil asked me a couple of weeks ago if there were computers when I started in Pharmacy. The answer was a resounding ‘no’. I was still using a slide-rule, let alone a calculator, when I did my final pharmacy exams in 1974. He followed on with the question ‘well, did you have self adhesive labels then?’ My answer was ‘yes’. We fed the roll through the typewriter to type our labels and they kept getting stuck on the roll, so you had to constantly pull the typewriter apart. In 1978, we did acquire an electric typewriter with a memory that stored information on a magnetic tape and improved the efficiency of typing labels (but you still needed two fingers). I seem to remember that this was about the time that we recruited our first dispensary assistant to type the labels for us. It is amazing to think we progressed from typewriters to the sophisticated computer systems we have now, in just 20 years. In 1985, the Australian Journal of Hospital Pharmacy (AJHP) published an article called ‘Consideration of applications and financial benefits of computer systems in hospital pharmacy’, and indeed, the theme of the 1987 Federal Conference in Hobart was ‘Basics to Basic’ with a strong emphasis on computer applications and justification. An AJHP editorial in 1987, described the role of computerisation in the continuing development of hospital pharmacy practice. In the same year the SHPA guidelines for the implementation of computer systems in hospital pharmacy were published, and the early 90s saw a proliferation of articles on a variety of programs, mostly developed in-house, with applications involving discharge prescriptions, printing of dispensary and IV admixture labels, stock control and formulation of TPNs. We acquired our first computer system in 1990 following the principles set out in the SHPA document to guide our selection. It printed dispensing labels, kept patient histories, produced picking slips for imprest supplies, printed orders for suppliers and provided a range of reports on drug usage. It is interesting that just as we all widely discussed, published on, and looked to pharmacy systems in the 90s, the same thing is being repeated today with electronic prescribing and medication management systems. I don’t want to delve too much into the history of clinical pharmacy; however, I would like to say that my first job in 1975 at the now non-existent Royal Canberra Hospital was as a ward pharmacist. Sure, our job involved replenishing the imprest stock and ward housekeeping, but we did review every chart every day (called treatment sheets then), primarily to identify and dispense the non-stock items. My boss then, Mrs Enid Barnes, was very progressive, and had already introduced a distribution system based on limited imprest stock and individual patient dispensing. It was a rudimentary review of the chart—we checked for legibility, completeness, drug 316 interactions and correct dosages, and that the nurses had administered all the doses. In 1975, the chart had no duplicate and we transposed the orders. I introduced one duplicate in 1985 that went backwards and forwards from the pharmacy to the wards, five duplicates in 1991 and now we are back to no duplicates. The clinical pharmacist scans the original order directly into the dispensary from the ward. And might I say, what a great achievement for us to now have the same medication chart in every public hospital in Australia! As a ward pharmacist in 1975, we taught extensively in pharmacology and therapeutics, because nurse training in those days was hospital based, and we instilled into the nurses the principles of right patient, right drug, right dose, right time, and right route. I am not sure that their training in this regard is as good today. The SHPA Ward Pharmacy Action Committee (which was the precursor to the Specialty Practice Committee) was formed in 1976 to facilitate the interchange of experience and ideas. In 1980, six clinical roles were defined for ward pharmacists in the Journal: evaluating drug therapy orders, noting potential problems relating to drug therapy and selecting parameters for monitoring, coordinating the collection of ADR reports, providing drug information and collecting drug usage statistics. In 1982, an Australia wide survey, which was published in the AJHP, showed that 60% of beds were covered by a ward pharmacist doing these jobs, albeit the average number of beds per pharmacist was 100, and the average time taken per bed was 2 to 3.9 minutes, 23% took less than 2 minutes. As ward pharmacists back then, we didn’t often talk to patients, charts were centralised at the nurses’ station so we didn’t really have a reason to go into their rooms. The shift from changing the terminology from ward to clinical pharmacist came with our increasing interaction with the patients during the 1980s and like other hospitals we changed to having the charts on the ends of the beds. The first SHPA policy guidelines for the practice of clinical pharmacy were published in 1986. This was the first document to define clinical pharmacy and list those activities required of a clinical pharmacist. Drug information developed as a specialty during the 1980s as a response to providing a depth of expertise to increasingly complex clinical questions. Canberra hosted the first drug information seminar when the Commonwealth’s National Drug Information Service was established in the late 1970s. We called the conference, ‘Alice in Wonderland’. In 1980, the Drug Information COSP was formed, minimum practice guidelines were published in 1983, and by the mid 1980s most major hospitals had established drug information centres. While talking about the establishment of drug information centres, I cannot miss mentioning the establishment of centralised IV admixture services in the late 70s. This is the specialty service to which I feel I have contributed the most in my career, and before becoming a Deputy Chief Pharmacist in 1980, was my area of specialty. In Canberra, under the stewardship of the great Mel Davis, the Parenteral Services Action Committee, with an oncology subgroup, was established in 1978. In 1979, we published on justifying and establishing IV additive services, published aseptic dispensing guidelines and conducted aseptic dispensing courses for pharmacists and technicians from around Australia. From 1977 to 1980, involvement of pharmacists in oncology services was a major growth area. Centralised cytotoxic reconstitution was first seen as a role for the IV additive service and became a major area of aseptic dispensing, but in 1980, it was identified that this may not be without its problems and the occupational hazards were recognised. It was the Parenteral Services COSP based in Canberra that first published Journal of Pharmacy Practice and Research Volume 37, No. 4, 2007
Page 1: The Fred J Boyd Award established i
Page 5 and 6: 318 GlaxoSmithKline Medal of Merit
Page 7: So where am I taking you with all t

Fred J Boyd 2007 Award - jppr

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