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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.  

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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?
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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.
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One of my favorite Spring Break memories is traveling with my family to Cozumel Mexico at age 15. Who would have thought I would still be going on Spring Break well into my late 20s! When you go through a rigorous pharmacy school curriculum, you really appreciate your precious time off. Our Class Officers organized a Class Trip to Puerto Rico. Around 70 third year pharmacy students flew out of a snow covered Baltimore to sunny San Juan.

In addition to soaking up the sun and hiking to waterfalls, we visited Eli Lilly. Puerto Rico is the 5th largest area in the world for pharmaceutical manufacturing (after the US, UK, Japan and France) with over 80 plants! The pharmaceutical companies originally came to Puerto Rico in the late 1960s and '70s to take advantage of a federal tax incentive. The tax incentive, Section 936, is now expired. Puerto Rico produces 16 of the top 20-selling drugs in mainland US. We visited a building a Eli Lilly that solely produced insulin lispro. Each day they make kilograms of insulin crystals that they send all over the world. It was an eye opening experience to see the extensive process that goes into producing one drug.

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In an ongoing effort to promote the usage of FDA-approved drugs, Cindy Ippoliti, Pharm.D., NYP/Weill Cornell, has authored a Drug Safety White Paper:The Hazards of Unapproved Drugs and Importance of Utilizing Approved Drugs.

Cindy was assisted by Christan Thomas, Pharm.D. and Frank Cirrone, Pharm.D. from NYP/Weill Cornell.

Each year dozens of drugs that are proven to be safe and effective are approved by the US Food and Drug Administration (FDA). However, many unapproved products remain on the market, “grandfathered” by older regulations.

The use of unapproved drugs can not only lead to legal action, but also poses a significant public health concern — particularly for those agents that have been previously “grandfathered” into the system. Once an FDA-approved formulation becomes available, early adoption is key for financial peace of mind, patient safety, and quality healthcare delivery. Continued use of non-approved drugs when a safe, FDA-approved product is available is not in the public interest and can lead to legal action.”

The Drug Safety White Paper is available at:

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Does reducing stress by changing your thoughts intrigue you?  This material is adapted from a monthly subscription service Mind Tools article on Cognitive Restructuring (CR). Key points are:

  • Stress often produces unhappy feelings and moods, which trigger “automatic beliefs and perhaps distorted thinking” that affects the quality of your leadership performance.
  • CR helps us to reframe the unnecessary negative thinking so you can approach situations in a more positive frame of mind so you don’t sabotage yourself.
  •  Eight steps are suggested. To illustrate these you have just been told that your request to add additional FTEs per participating in transitions of care has been denied for the second time. Needless to say as the pharmacy leader you are upset, frustrated and stressed out because you know what patient care value your clinical staff could bring.  Your thoughts are all over the place including should I find another job, what did I do wrong, why can’t I sell this as the organization is adding hospitalists, etc.
  1. Calm yourself. Rather than allowing yourself to get angrier and stressed take a few minutes to take a few deep breaths and pause to relax your thinking. Perhaps take a walk, compliment a staff person, ask the staff how things are going, just listen to music or anything that shifts you out of your automatic negative reactions.
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Balance has become a theme intertwining many of the topics and challenges reflected in my posts as a new practitioner. The recent months have exposed me to new challenges as my transition period comes to a close and I become more invested and take on other roles as part of my clinical pharmacy specialist position. One of these roles was an experience as the primary rotation coordinator and preceptor for a student rotation.  

Like many residents, I completed a formal teaching certificate during my first year residency and continued utilizing that information through my PGY2 residency. I applied my skills directly to students on rotations and met with my teaching mentor regularly to think about hypothetical situations and take on additional assignments to gain experience in coordinating rotations, reflecting on didactic opportunities, and working on my teaching philosophy. I left thinking the rigor and multi-faceted focus of the program gave me adequate armament in educating the next generation of pharmacists.

Despite all of the “hands-on” experience, there is no way to truly prepare for the spectrum of student learners that exist or the challenges of time management in coordinating patient care responsibilities, being an effective teacher, and ensuring that a student’s time with you is optimized with topic discussions, other presentations and projects, and school enforced didactics. In the process of becoming a good preceptor, I’ve discovered more questions that I had never thought through before.

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General : Precepting  Audience : New Practitioners, Resident

What does decisive mean to you? Based on the title, you might assume this book is all about making quick decisions, but the purpose of Decisive is to describe “How to make better choices in life and work”.1 Decisive provides a lot of worthwhile advice, and Chip and Dan Heath do not spend a lot of time offering platitudes to solve real life problems. The platitude type of book offers nothing new and is usually a waste of time. You know…like a book with an entire chapter about the importance of good communication, which makes me think, “Oh you are saying good communication is important? No wonder I can’t get ahead. I thought bad communication was the way to solve problems!” You might have noticed this is one of my pet peeves!
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General : Leadership, Management, Professionalism

Leadership at all levels is needed if we are going to seize the many opportunities that the healthcare reform offers us.  Do you need a “booster/refresher” in leadership or are there people on your staff that could be more effective if they possessed leadership skills?  Also whom have you identified as your successor or for other key positions? Two totally on-line (no travel required) six week courses, Leaders INNOVATION Master Series beginning April 12 are being offered by the Leadership Center of the ASHP Foundation .  Because of the design of these courses the participants benefit from the experiences of not just the faculty but all their colleagues.  It is like having 20-30 mentors/mentees that continue after the course. An example is the Favorite Interview Questions Jan 26 Connect blog post, which came from the weekly Threaded Discussion Question responses and comments.  Each of the six weeks has a 10 minute narrated Power Point presentation by the faculty, provided readings from the leadership literature, a Threaded Discussion (TD) Question and a reflective Journal (J) Question. Faculty provide weekly feedback/comments on each person’s TD and J responses. A Case can be worked on in a group or completed individually as an additional way to apply the material. Two optional live discussions by the faculty and participants provide live dialogue opportunities. The following describes these two offerings.

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I work in a large company where alignment between the corporation and its local business units is an area of constant attention. Perhaps because of that, I tend to be somewhat sensitive to instances where there may be misalignment.

Today I received a missive from my ASHP state affiliate urging my support for an initiative to defeat a law that would extend the number of technicians a pharmacist can supervise. This letter caused me to wonder at how technician-to-pharmacist ratios applied to one of our most significant national projects, the Pharmacy Practice Model Initiative (PPMI).

This should not be misconstrued as criticism of the effort. I just found myself wondering whether the drive to preserve a relatively low technician-to-pharmacist ratio was consistent with our national endeavors. I was there at the initial PPMI convocation, and it was clear at the time that the development of a well-trained and properly credentialed technician workforce who would operate our dispensing systems was crucial to realizing our professional aspirations.

What evidence to we have that such ratios protect patient safety? What evidence do we have that one ratio is better than another? If ratios are appropriate, what evidence do we have that one ratio applies properly to all types of pharmacy practice?
2 people recommend this.
General : Leadership, Patient Safety, PPMI

Are you a member of your state professional health-system pharmacy organization? These organizations are also known as ASHP state affiliates.  Being a member is a great opportunity to network with local pharmacists and student pharmacists, discuss pertinent issues that affect health systems within your state, and get involved in leadership activities.

I feel very fortunate to  belong to the Illinois Council of Health-System Pharmacists (ICHP).  I have been a member of ICHP since I was a student.  There are several networking events including legislative day, the spring and annual meetings, the leadership retreat, as well as other continuing education (CE) presentations and events.  ICHP has various committees that members can join to work on specific projects for the organization. They are also very involved with the student affiliates (SSHP) supporting events like the clinical skills competition, membership drives, and the student leadership retreat.

As a student, it seemed easy to get involved in professional organizations because there was always information readily available on campus.

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General : Leadership, Membership, Volunteering