Spotlight: Faces of Pharmacy Services
The inpatient and outpatient pharmacy teams at Cape Cod Healthcare both play an important role in patient care and the health of the community.
The pharmacy departments at Cape Cod Healthcare have two faces: a public face and a more private one. The retail pharmacies in the lobbies of Cape Cod Hospital and Falmouth Hospital fill prescriptions, much like a drugstore, and assist the public and CCHC employees on a daily basis.
Behind an unmarked set of double doors at both hospitals, in-patient pharmacists and technicians are busy preparing prescriptions for patients and distributing the drugs inside the hospitals to the patients’ rooms. Regardless of their location and responsibilities, both departments play an important role in patient care and the health of the community. We recently visited with both teams to provide an inside look into each department’s daily functions.
Outpatient Pharmacy Services
At Falmouth Hospital (L to R): Martha Handel, Andrea Fogarty, Donna Downarowicz, Courtney Kelly
James Citrone, Lead Community Pharmacist at Cape Cod Hospital
At Cape Cod Hospital (L to R): Courtney Kelly, Angela Medeiros, James Citrone, Christina Vigneau, Dan Solomon, Ashely Aytek, Lori Silva
At Cape Cod Hospital (L to R): Jennifer Bassett, Laurie Hahesy, Maria Michaud, Mitch Summey, Deirdre Doucette
The Cape Cod Hospital and Falmouth Hospital retail/specialty pharmacy teams consist of 25 people. Last month, they hit an all-time high, filling 10,438 prescriptions in one month. In 2009, the retail pharmacy opened as an employee-only pharmacy. Several years later, both pharmacies moved to a centralized location in the front lobbies and opened to the public (Cape Cod Hospital in 2016 and Falmouth Hospital in 2017). “It has been very rewarding to be able to help our employees and the community,” says Angela Medeiros, Director of Outpatient Pharmacy Services for Cape Cod Hospital and Falmouth Hospital.
“We provide multiple services, from prescriptions, counseling and vaccines to over-the-counter recommendations,” says James Citrone, Lead Community Pharmacist at Cape Cod Hospital. The team also makes it convenient for customers by offering curbside pickup for prescriptions at the main entrances of Cape Cod Hospital and Falmouth Hospital.
The pharmacies in both locations offer convenience and expertise from local hospital experts. CCHC employees on the health plan receive a discount on prescription co-pays and all CDC-recommended vaccines are free of charge. All employees receive an over-the-counter discount, regardless of health plan status.
The pharmacy at Cape Cod Hospital is open 365 days a year: Weekdays from 7 a.m.–7 p.m. Monday through Friday, and 8 a.m.–4 p.m. on the weekends. Falmouth Hospital’s pharmacy is open 10 a.m.- 6 p.m., Monday through Friday (closed weekends and holidays).
Hospital and Ambulatory Pharmacy Services (In-Patient)
At Cape Cod Hospital, back row: Jim Mangan, April Garbitt, Caryn Wheeler, Lola Alade, Bonnie Lohr. Front Row: Oei Yuen, Anna Catania, Judy Park
At Falmouth Hospital (L to R): Maria Wylag-Lumsden, Trish Antone, Laurie Beitler
At Cape Cod Hospital, Technician Caryn Wheeler scans medication at the carousel, which dispenses medications.
At Falmouth Hospital (L to R): Kim DeWitt, Joe Andrade, Laurie Beitler, Trish Antone, Deb Ferriter
The main difference between in-patient and retail, explains Anna Catania, staff pharmacist/inpatient pharmacy at Cape Cod Hospital, is that in retail, you are dealing with prescriptions and you’re talking with patients daily. With in-patient pharmacy, staff is working behind closed doors, reviewing orders on the computer and having much less patient interaction. “We’re mainly dealing with nurses and doctors to clarify things, and we have access to a patient’s lab work,” says Catania, who started her career in CCHC’s outpatient/retail pharmacy department.
Catania adds in-patient pharmacists make IVs and make sure doses are specific to a patient’s needs. “I think I learn 75 new things every day,” says Catania. “I feel like there is a lot of new information, and everything is constantly changing.” To keep up with the changes, the team reviews guidelines regularly and must complete required education both internally and for the state.
The inpatient pharmacy department is a 24/7/365 team made up of pharmacists and technicians. There are about 30 pharmacists and technicians at Cape Cod Hospital and 15 at Falmouth Hospital. A typical day shift in the main pharmacy consists of four pharmacists and three technicians; two pharmacists and two technicians in Oncology; and a technician gathering home medication lists in both Emergency Centers. Technicians also restock all the OR’s and Cath Labs at both hospitals in the evenings.
Pharmacists are responsible for unique and complex tasks. This can include: compounding injectable medications, checking IV therapy treatment plans and patient-specific medications, reviewing daily clinical reports, monitoring lab reports for changes (and adjust medication dosages when requested or in some cases as allowed by the organization), verifying patient specific orders and contacting doctors for any clarifications, where appropriate. In the middle of the night, there is even a pharmacist that covers orders for both Cape Cod and Falmouth Hospital.
The inpatient team also consists of technicians, who handle drug distribution—making sure drugs are delivered to the floors and to patients. They also stock medications, make IVs for patient care, deliver meds, properly package meds for distribution and manage in-date and out-of-date medications. They also maintain carts for anesthesia providers and make sure they are all up to date.
Technicians work with the Pyxis MedStation, similar to a vending machine, which dispenses the medications. It helps clinicians safely and efficiently dispense the right medications for the right patients at the right time. The medications are individually packaged and bar-coded with instructions so a nurse can scan the label to make sure they are the right ones for patients. All medications are labeled and bar-code driven.
Last month, on average, about 147,000 doses of medication were distributed at Cape Cod Hospital and about 48,000 doses at Falmouth Hospital. At the cancer center, 1,160 doses were prepared for chemotherapy patients in September.
“The hospital has given us great technology, in terms of bar-code scanning, inventory management software, EPIC, and new safety tools we didn’t have before,” says James Mangan, Director of Hospital and Ambulatory Pharmacy. “The administration has been very supportive to make sure we have the right technology available to do this in the safest way possible.”
