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Medication Use System and Technology (MUST) Pharmacists are experts in the medication-use system and take on advanced responsibility in the areas of pharmacy operations, technology/automation application, medication safety, data analytics, quality improvement and compliance, technician oversight and training, medication compounding and preparation, and education/training related to the medication-use system.

The SOPIT Operations/Automation SAG has devoted resources to create discussion on the value of MUST from a departmental perspective and in determining "best fit," part of which is asking the right questions.

The following survey relates to development of the MUST role.

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Hello Everyone! I am honored to be selected as one of the recipients of the 2013 - 2014 ASHP Student Leadership Award. As part of this award, we were asked to share the essay we wrote about engaging students in the Pharmacy Practice Model Initiative (PPMI) and ways to increase student's awareness of PPMI. If you have any comments regarding the ideas I have outlined in my essay below, please feel free to leave a post on this blog or contact me directly. I would love for this essay, as well as the other recipient's essays, to create open dialogue about a topic so important to our profession! Happy reading! :)
Engaging Students in the Pharmacy Practice Model Initiative
By: Lauren Grecheck, Pharm.D. Candidate 2015

1 person recommends this.

We all have bad days. Perhaps not routinely as bad as Alexander in the children’s book “Alexander and the Terrible, Horrible, No Good, Very Bad Day,” but still bad enough. You know you have the makings of a bad day when you 1) discover an ant infestation a few thousand strong in your kitchen, 2) scald the inside of your mouth on your morning coffee before spitting it out (managing to nail your favorite sweater in the process), 3) realize that your very sweet (but very bad!) male cat has once again decided to pee outside the litter box for no apparent reason, and 4) get pulled over by Portland’s finest for an expired registration (thank you so much Oregon DMV for taking your time in mailing me my stickers—late!) all before noon. Yep, all the makings of a very terrible, horrible, no good, very bad day.

Working in health care, we are on the front lines of people’s bad days all the time. And unlike the relatively minor messes of daily life, the kinds of bad days our patients experience in the hospital are not nearly as forgettable. Cancer. Heart Attack. Stroke. Infections so bad you lose a limb. These are not the kinds of experiences you can walk away from unchanged, like some stupid ants or a stain on a sweater. On a recent stretch in the ER, I had two such patients. One was a 30 year old experiencing non-specific symptoms of abdominal pain and fatigue, who was found to have perforated colon cancer with extensive metastases to the brain. The other patient was a 52 year old experiencing dizziness at home, found to have extensive stroke, which resulted in brain death. For the 30 year old, there was the shock of a terminal diagnosis and possibly a few more months of life when she/he had planned for an entire lifetime. Imagine being told you will have no more birthdays, no children. For the significant other of the 52 year old, the shock of having someone you love be with you one moment, and the next moment they are gone. Imagine not being able to say goodbye. There aren’t words for how terrible these experiences are. The actor just leaves the stage while the play of life goes on. It feels weird and wrong, and no matter how many times I experience it with my patients and their families, it leaves a mark.
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Would improving your focus assist you in being a more effective leader? The following suggestions are adapted from Joe Tye’s Spark Plug Newsletter. He is a former hospital administrator now a leadership coach who spoke at the ASHP Leadership Conference several years ago. Check out his website, which has a number of leadership materials in addition to his Newsletter. I find his material quite practical.

  • Today the focus challenge/struggle is trying to pay attention to everything all at once and thus losing productivity. Remember focus involves your time and energy. The following are ideas to improve your focus.
  • Define your one Big Yes. What is your overarching leadership purpose/vision/goal? Defining it helps you close the door on the trivia that really doesn’t make a difference?  Focus depends on a lot of little no’s. Think about posting your Big Yes where you frequently see it so as the leadership fire hose is coming at you it doesn’t get lost.
  • Use DDQs (Direction Deflection Questions). Use some variation on the following. Is what I am about to (do, say, spend my time/energy on, etc.) going to help me achieve an important goal?  Again having this question in front of you constantly can be of assistance in your minute-to-minute decision making.
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Hello everyone and welcome to my first ASHP Connect Blog Post!

I am honored to have been named as one recipient of ASHP's Student Leadership Award for 2013-2014. Congratulations to the other 11 recipients! As part of the award application, students submitted a plan to increase awareness and understanding of the Pharmacy Practice Model Initiative (PPMI) among student colleagues. My essay is provided below; please feel free to comment or ask questions!

As a future pharmacist, I believe it is imperative to recognize current challenges in our profession and potential solutions to these issues. As a student leader, I have the potential to convey the thoughts and ideas of small, focused discussion groups to large student bodies as well as suggest activities to include in the professional curriculum. As the pharmacy practice model changes, it is crucial to be aware of the future direction of our profession and the likely influence on practice models. Not only does the Pharmacy Practice Model Initiative (PPMI) change the typical administrative and logistical design of the pharmacy staff; it most prominently modifies the approach pharmacists will utilize in providing patient care, reducing medication errors, and improving medication-use expenditures and safety. Therefore, student education and awareness of PPMI will ease the transition to new practice models as well as foster creativity and innovation in its future design.

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General : Leadership, PPMI  Audience : Pharmacy Students

As if you haven’t heard the words “let it go” enough from the Idina Menzel song of the same name either on the radio, on DVD, or from any 6-year old child, you will hear it a few more times in my blog. Hopefully, you don’t react to my version of the words in the same way as you might the overplayed song (interpretive and dramatic dance is okay…turning the channel is not).

In my 10 years at The Ohio State University Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, I have been witness to and part of expansion and dramatic changes in operations. In fact, as type this blog I am waiting for construction workers to finish in one of our chemotherapy infusion pharmacies, one that has moved 4 times in 10 years. I have designed and opened 2 new infusion pharmacies (not counting the one we’ve moved 4 times), led the implementation and workflow design for an EMR implementation in the ambulatory infusion centers, directly hired almost 50% of the 133 people in the department, and have probably made every mistake…and learned from them. So, yeah, I feel like the inpatient and the outpatient pharmacy departments are my children, like Elsa and Anna of the movie.

6 people recommend this.
General : Careers, Leadership, Professionalism

Ever feel like you have no time to keep up with hot topics or news in pharmacy and healthcare system? I have the same thought at times. My name is Phuoc Anne Nguyen and I am the first year in the combined PGY1/PGY2/MS Health System Pharmacy Administration Houston program at the Michael E. Debakey VA. With residency’s responsibilities, I sometimes struggle to find a work life balance while staying updated with the medical literature. That is the reason why I would appreciate to have a journal club that covers different hot topics to keep updated!

Therefore, as a member of NPF Leadership and Career Development advisory (LDAG), this idea of journal club was proposed and accepted. Therefore, LCDAG and Communication and TechnologyAG (CTAG) NPF have joined forces to launch a nationwide journal club on ASHP Connect. The journal club will encompass a variety of topics to include hot topics in healthcare, pharmacy practice pearls, clinical pearls, residency-related topics, best practices, and many more.

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Thank you to ASHP for naming me one the 12 recipients of this prestigious award. The application allowed us to write about increasing awareness and understanding of the Pharmacy Practice Model Initiative (PPMI) among student colleagues. I am proud to share to my essay.

One of the keys to success is being adaptive to change. The profession of pharmacy is always changing and progressing, as evidenced by the Pharmacy Practice Model Initiative.

At my internship experience this summer, I finally understood what PPMI is all about. I had the opportunity to sit down and discuss the article “Believing what we know: Pharmacy provides value” by Burnis D. Breland, with Scott Knoer, PharmD, MS, Chief Pharmacy Officer of the Cleveland Clinic. Discussing this article with Dr. Knoer, I realized that I was seeing PPMI in action every day at the Cleveland Clinic. New technology was being put into place, like a piloted program for electronically tracking drug boxes and their contents throughout the hospital; training programs were improving like the new school of pharmacy technology with didactic course work and rotational experience; increasing residency, internship, and APPE opportunities, which allows for layered learning; professional development as seen by the integration of pharmacists on the floors and rounding with the interdisciplinary team; increasing specialties, certifications, and defined roles; accountability and opportunity for growth, feedback, and change with the goal of improved patient care. This is just the surface of PPMI, and it is time to get all of the health-systems on board.

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I’m the type of person that LOVES conferences.  I learn a ton from the offered continuing education, I attempt to beef up my CV and share my knowledge either through a poster or presentation, I thrive on the networking opportunities with old and new colleagues, receptions and dinners, and I enjoy exploring the chosen conference location.  Last year, I attended the ASHP Summer Meeting in conjunction with the Medication Safety Collaborative for the first time and didn’t know what to expect.  Part of me thought it would be exactly like Midyear minus the chaos and adrenaline surrounding the Residency Showcase and Personal Placement Services.  I was wrong.  The tone and pace of Summer Meeting was very different; the pace was slower, more relaxed and the networking and conversations seemed much more casual and personable because of the smaller scale Meeting.  Both Meetings are phenomenal, so I would recommend both to anyone that has the time and money to attend!

This year the ASHP Summer Meeting is again expanding because of the great success that came from last year’s Meeting with the Medication Safety Collaborative.  This year they are keeping the Medication Safety Collaborative but also tagging on the Informatics Institute (I2) and the Pharmacy Practice Policy (P3).  I can’t even imagine what things are coming down the pipeline to discuss at the I2, but know that the most current issues surrounding policy will be highlighted at the P3.  The interdisciplinary nature of the Medication Safety Collaborative was probably my favorite feature last year- nurses and physicians heard what we as pharmacists were doing and were thoroughly impressed.

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Ever have a bad day?  A Mind Tools Club, a monthly subscription services’ 10 Ways to Make a Bad Day Better discusses the following:

  • Acknowledge that bad days are part of life but the key is we can chose how we react to them and effective leaders do so using the following advice.
  • Reach out which means contacting a mentor, colleague, friend and see if they have time for a cup of coffee or call. Often just talking about what is bothering you can release the negative feelings as can writing in a journal. When you explain why you are upset you can change your perspective release negative feelings and move on from the situation.
  • Go for a walk because taking a few minutes to “get away” shifts your thinking.  If possible go outside but talking with your people also may put things in perspective.
  • Achieve a “small win” so take a minute to look at what you are trying to achieve and find a piece that you can achieve which enhances your mood/motivation and can distract your negative thinking.
  • Be grateful means stop and consider all the good people and successes you are having as a leader.  It is common to focus on what isn’t happening as you would want that you forget what has gone right.  Think about keeping a “Success/Victory” log so on a bad day you can refer to it.
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Pharmacists are particularly adept when it comes to figuring out the most efficient ways to do things. It seems like whenever I introduced a new policy or practice to my pharmacy department colleagues, there would be dozen of suggestions for a very efficient way to get this new job done. Most of these suggestions were offered before I was even close to finishing the introduction! It is so easy to start out with the intention to do the right thing and end up instead doing the most efficient thing. I think as pharmacists we need to be alert to this tendency and always keep our guard up. 

One way to protect against the tendency to do the most efficient thing is to build in a bias in favor of pushing the envelope rather than in favor of maintaining the status quo. After all, how safe is the status quo? Can we best secure our future by protecting the status quo, or instead by having a focus on protecting our patients? If our focus was to push the envelope to protect patients, would we have looked differently at recent healthcare initiatives such as the Risk Evaluation and Mitigation Strategies (REMS) developed by the FDA; at Medication Reconciliation Strategies promoted by The Joint Commission (TJC); or even medication teaching? The REMS program proposed by FDA was an opportunity for pharmacists to take the initiative to enhance medication safety and not intended to be just another bureaucratic obstacle to efficiency. Patient Education is another example. Asking a patient to sign a register to verify they don’t want to speak to a pharmacist doesn’t achieve any goals to educate patients about their medications. Of course, time pressure is often used to justify why certain processes were put into place. However, did we stop to consider the risk we were taking by not enhancing our responsibilities instead of substituting with processes aimed only at increasing efficiency? What did it cost us in terms of our future by maintaining the status quo? 
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General : Leadership, PPMI, Professionalism

There are some obvious challenges in the transition from student to pharmacist.  After the dust settles from the initial whirlwind of change, a less obvious challenge may arise.  For me it was early in my professional life that I realized that something was missing.  I had spent the last 17 years of my life working hard and judging my success by the grades that I received each semester.  And there were always reasons to strive for good grades.  In grade school grades are mostly to please our parents.  As you get older you realize that you need good grades to get into college.  In college you need good grades to get into professional programs and hopefully to get scholarship monies.  But once you enter the professional world, there are no more grades to benchmark your success or failure.  I realized what I was missing was that feeling of getting an A for a job well done!  True, most companies require some type of annual performance evaluation but they often lack robustness.  No doubt, if you make mistakes or fail to complete a task in an efficient manner, you will hear about it.  But more often than not you are left alone with your self-evaluation and your self-motivation.  

2 people recommend this.
Audience : New Practitioners, Pharmacy Students, Resident

Brace yourself…it is time for the April CTAG App of the Month!

App: Shots by STFM
Platform: IPhone and Android
Category: Medical,
Price: $3.99 per download
Ratings: 4+

Shots 2014 Immunization Schedules by STFM is for healthcare personnel providing vaccines or vaccine information.  In the November 28, 2013 ISMP Newsletter discussed the most common immunization errors which included “unfamiliarity with the vaccine, particularly its dose, dosing schedule, age specifications, route of administration, and the vaccine’s various components.”  This app can help reduce those prescribing errors by providing valuable information which includes the unified 2014 CDC childhood and adolescent schedule, the catch-up schedule, the adult schedule, and the adult medical indications schedule.  Each vaccine is covered in sections on the basics, special indications, catch-up, side effects, contraindications, precautions, and contents with additional sections on epidemiologic information about each disease.

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Mentorship is a very significant aspect of leadership development.   A mentor shares wisdom and provides guidance to a mentee.  Mentoring is a learning relationship.  One of the most important facets of leadership is influence, and when you are mentoring, you are providing influence to an aspiring leader.  It is important for pharmacists to be mentors, as many younger pharmacists need the advice and guidance of pharmacist mentors to develop and enhance their leadership skills. 

A mentor should be someone that a mentee can respect and trust, and has been through the things the mentee will be experiencing.

3 people recommend this.

At last, we are starting to see warmer weather signaling the late arrival of spring!!  Spring often represents new starts; in the pharmacy world this correlates with new pharmacists graduating, matching to residencies/fellowships and much more.  On behalf of the New Practitioners Forum (NPF) Professional Practice Advisory Group (PPAG) we would like to wish those beginning a new adventure in their pharmacy careers the best of luck!


On the flip side of new beginnings, we have endings and here with the NPF PPAG we are finishing up with the near completion of the sepsis and anticoagulation reversal Pocket Topics.  PPAG members have searched far and wide to compile relevant literature to develop our Pocket Topics on sepsis and anticoagulation reversal.  I am proud to report that we have compiled what we believe to be a very comprehensive selection of literature.

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When people ask me how I decided to become a pharmacist, my answer is really quite boring. Reflecting back on my teen years, I was like most 13 year olds where my mind was never in the present always fast-forwarding into visions of the future. However, I was that nerd that took an eighth grade homework assignment for researching future careers very seriously. High school was around the corner and I had to know what “track” to take and of course it’s easier to plan when you have an end goal in mind. A little bit of the decision aligned with stereotypes too. My parents had struggled in my youth to provide me with every opportunity for success including moving from India to America. A career in healthcare would give me job satisfaction, security, and, ideally, the balance I needed to raise a family.

Throughout my short professional journey, I was always involved. I worked off of my own “success” template of working hard and taking advantage of the opportunities available during high school, college, and pharmacy school. I was active in student organizations, interning, volunteering, traveling with medical mission trips, and I genuinely believed this was professional engagement. Involvement in these activities was also motivated by a selfishness to fulfill my joy of staying busy and bolster my CV to appear well-rounded enough to entice someone to invite me on-site for an interview for whatever opportunity was next. If you ask students, residents, and post-residency graduates what professional engagement means, you will often get a laundry list of all the activities they are involved with to fulfill the need for “looking good” on paper. Landing my current job has been the pinnacle of achieving a pseudo-defined long-term goal I set as a 13-year old. Being about 9 months out of my PGY2 oncology residency, I realized I needed to reassess my tactics and what professional engagement really means in a more global sense of my career. When I completed residency, two pages of my CV were easily erased with things that were no longer relevant and I felt a bit naked with nothing to show for myself after the laborious years spent coming to this achievement.

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 Would you like to get more accomplished in less time? Pozen in Extreme Productivity Boost Your Results, Reduce Your Hours provides the following suggestions.

  • Shift your mindset from hours worked to results produced.
  •  Have you set and prioritized your goals why are you engaging in any activity and what do you expect to get from using your time this way
  • Three big ideas. Document a list of everything you are required to do including projects. Divide your list into three time categories: Career Aims (5+ years), Objectives (3-24 months) or Targets (1 week or less).  Be sure each objective has at least one target.  Rank your objectives 1-10 (highest) by thinking about what you want to do, what you are good at, and what the world and your boss needs from you. Divide and rank your targets into enabling and assigned.
  •  Estimate how you actually spend your time. Ask yourself how many hours do you spend at work? What are the three main activities you spend the most time on and how much time do you spend in meetings, responding to ems and other routine tasks. Address any mismatches between priories and time spent such as if you aren't spending the majority of your time on your top priorities.
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For many pharmacy students, Match Day has come and gone. There was a time of CV crafting, going to residency showcases, attending Midyear, poster presentations, PhORCAS, sending applications, the trepidation of interviews, and their final ranking of preferred sites.

Many have matched, and many did not. For those that matched, their Twitter, Facebook, and every other social media outlet exploded with their happiness and announcement of what they are doing next year.

However, for those that did not, there is only silence or self-disappointment. But it's not over. That's what I want to say.


I think there are several emotions that happen. Anger, resentment, sadness. These are all natural. I have met students that blame themselves, for not choosing more sites to send applications or if they made a mistake. Others will blame the Match itself, the profession, the lack of positions available. Many will question if they weren't good enough. They see classmates who have matched, and see faculty congratulate them. What about those that did not match?
3 people recommend this.
General : Meetings, Midyear Meeting, PhORCAS, Residency  Audience : Pharmacy Students

There’s no doubt about it, the match can be a very stressful process. Not only do you have to determine what program offers the best opportunities for you and how you fit in with that program, but you also have to determine where you want to live for the next 1-2 years. It’s pretty incredible though when you look back at the sequence of events that had to happen to get to that point:

  1. Determining what programs you’re applying to

  2. Filling out PhORCAS application(s)

  3. Writing letters of intent

  4. Requesting letters of recommendation

  5. Scheduling and preparing for interviews

  6. Flying/driving hundreds of miles to interviews

  7. Interviewing

Finally, after all of that you’re rewarded with an enormous decision and a 50% stake in deciding where you’ll be at next year. And then you wait for 2 weeks!

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General : PhORCAS, Residency  Audience : Pharmacy Students

ASHP headquarters has been in Bethesda for 48 years and in our current building at 7272 Wisconsin Avenue for 22 years. It has served as a welcoming home for members and staff, providing us with quality office space to host members and guests, and to conduct meetings and events. 7272 Wisconsin Avenue has provided convenient access to Metro, easy access from all three of the region’s major airports, and proximity to an array of local restaurants and hotels to host our members when they are in town. The building has been a valuable asset to ASHP that has grown in value and continues to provide ASHP with revenues through lease of both retail and office space. One year ago we conducted a ceremony naming the building the Joseph A. Oddis Building in honor of Dr. Joseph A. Oddis, who served as ASHP’s Chief Executive Officer for 37 years, and whose vision and leadership led to ASHP acquiring the building in 1992.

Since moving to this location, both ASHP and Bethesda have grown. The building sits atop the south end of the Bethesda Metro station, and plans have been in place since the building was constructed to develop and build a new southern entrance to the Bethesda Metro station and add a new light rail service connected to the Metro, called the Purple Line. This new rail line would connect Bethesda with points further east, and would be built on an old railroad right of way that currently houses the Capital Crescent Bicycle trail – a popular hiker-biker trail. Recently, design studies revealed that it would not be feasible to construct the new stations and maintain a bicycle trail within the existing tunnel under our building, and that space limitation would limit design options for the transit stations. As a result ASHP was approached by the County regarding our willingness to explore the sale of the building to permit redevelopment of the site. To incentivize ASHP, the County is currently engaged in rezoning of several blocks here in Bethesda and exploring other incentives. Previously, the plan had been to use the existing tunnel under our building for the Purple Line and to reroute the hiker-biker trail. The County approached us with a plan to combine the two under the building and build a larger metro station that would require demolition of the building. This is now the County’s preferred option, and we are therefore currently exploring it.
1 person recommends this.