November/December 2009 - Ontario College of Pharmacists

patient safety
The article below first appeared in Dialogue, the journal of the College of Physicians and Surgeons of Ontario.
Pharmacist-physician
collaboration
key to patient safety
COMMUNICATION CAN STRENGTHEN WORKING RELATIONS
A
group of pharmacists and
physicians in southern
Ontario has developed a
number of communications tips designed
to provide safer, seamless,
more efficient care to patients.
The Ancaster-Dundas Pharmacist-Physician
Collaboration project
developed a set of easily implemented
protocols to strengthen
physician/pharmacist working relations
and improve patient care.
The recommendations specifically
aim to: reduce unnecessary
calls/faxes between pharmacists
and physicians; enhance patient
care; facilitate up-to-date patient
profiling at the pharmacy; allow
monitoring of patient adherence and
re-enforcement of the most current
directions; prevent discontinued
medications from being ordered in
error; and improve availability of a
current patient profile for planned
or unexpected hospitalizations.
Dr. Lori Chalking, a family physician
in Burlington, was one of the
physicians involved in developing the
recommendations. Her family practice
has been using them for several
years now, with excellent results.
“As health-care professionals, it is
so important that we communicate
regularly to ensure our patients are
getting the best and safest possible
health care,” she said.
Ms. Kerry Monaghan, a Burlington
pharmacist, said she was
recently made aware of the need
Recommendations to Decrease Unnecessary Calls/Faxes
Communication
Item
Dosage Changes
Discontinued Meds
Prescription Directions
Potential Allergy
Potential Interaction
CPSO Number
Multiple Office Locations
Physician Action
Write on Rx:
• intention to change dose of
prescription
• subsequent verbal changes
communicated to pharmacist
Write on Rx: intention to stop or
change prescription
Write on Rx: Complete dosage
instructions as discussed with
patient rather than as directed
Write on Rx: “aware of allergy –
will monitor”
Write on Rx: “aware of
interaction – will monitor”
Include your CPSO number on
all prescriptions
When the prescription includes
several office or hospital
locations, indicate where the
patient was seen
for enhanced clarity in regard to the
patient’s medication treatment plan.
“A patient was discharged from the
hospital and the cardiologist had
discontinued the patient’s warfarin,
which he had been taking for atrial
Pharmacist Action
• Reinforce rationale for change to
improve adherence
• Update patient profile
Ensure patient understands rationale for
change & note discontinued med as
“inactive” on profile to prevent
inadvertent refilling
Reinforce physician directions & assess
patient adherence
Counsel patient on potential signs &
symptoms; document patient-specific
allergy & follow-up with patient to
determine tolerance
Counsel patient on potential signs of
interaction; follow-up with patient to
determine tolerance
When there is difficulty deciphering your
signature, the pharmacist can check the
CPSO website to ensure correct spelling
of your name and contact information
Ensure the correct location is entered
on the patient file, to facilitate future
communication, when needed
18 pharmacyconnection • November/December 2009