Innovative Pharmacist-Doctor Collaboration Improves Rural Care for Couple
By Jarett C. Bies
Teaming up to complete big jobs is part of life in rural areas, be it snow removal on country roads in the winter, planting in the spring or combining come fall – it’s natural for folks to make light the work with many hands.
That same approach is taking place between health care professionals at Redfield Community Memorial Hospital Avera, too, where a clinical pharmacist is playing a more comprehensive role in medication management with patients. The approach allows for a more focused medication management, and it ensures the people who need this expertise are getting it.
Aly Howard, PharmD, serves as the clinical pharmacist at Redfield Community Memorial Hospital Avera, as well as Marshall County Healthcare Center Avera in Britton. At both sites, she provides a range of hospital pharmacy services, including patient-chart review, medication management and antibiotic stewardship efforts including dosing recommendations. She also consults with medical staff and serves to provide basic pharmacy-operation oversight.
In Redfield, she offers unique patient-centered services such as an anticoagulation clinic management, continuous glucose monitor placement and diabetic consults.
“It is unique to have a clinical pharmacist in a smaller facility,” said Howard. “When we considered this model, I suggested we approach it collaboratively, with patients as the central focus, where I could lend my expertise and aid the medical staff at the hospital and clinic with a number of medication-related services.”
So far, the program has been successful, and it helps patients like Marge and Dick Gallup, who spend time with Howard as well as their physician, Matthew Owens, MD. Marge Gallup said Howard’s acute understanding of all things medication gives her a deep resource to address her husband’s diabetes as well as her own condition.
“I have had a few challenges, including a stroke and a pacemaker, so working with Aly (Howard) has been a real help, as she is quick to note changes and to try things out to help me with anticoagulant medication, as well as Dick’s insulin,” Marge said. “She’s a true professional, and she takes the time to personally review the information so I feel I am in good hands. She and Dr. Owens work together really well.”
Starting New, Creating Collaboration
As a pharmacy student, Howard spent time at Redfield Community Memorial Hospital Avera and came to realize the need for her discipline in this rural setting. A physician who worked with her also saw her gifts and championed the idea of developing a clinical pharmacist position in the small Spink County community.
“Medication management can really make a big difference for many patients, including people like Marge who use anticoagulants to avoid blood clots. Diabetes patients, as well as those using hypertension meds, also can benefit when they have extra time and expertise in their care teams,” she said. “The patient gets more time one-on-one with me, and that clinical time can give advanced practice providers and doctors another ‘brain’ to pick when considering medication approaches. It can also help them in terms of time management. Medical care is growing more complex, almost every day, and to provide it effectively, we’re required to offer more specialization. This service is another example of these efforts to provide that best possible care.”
Dick Gallup said Howard’s insight has helped him to evaluate insulin monitors he uses to address his diabetes. “I was having some low-glucose issues, and she was able to help me straighten those out,” he said. “She and Dr. Owens worked together, and they helped both Marge and I with our medication use. She’s a great resource.”
Dick and Marge’s physician, Matthew Owens, MD, said Howard’s support of his care has been beneficial to all the medical staff in Redfield.
“Having another professional you can collaborate with on complex cases always helps, and Aly’s expertise gives me an advantage that many providers may not have,” Owens said. “Beyond the expertise and professionalism, she is a natural with patients and really makes them feel more comfortable because she explains our medication approaches clearly and in ways that allow patients to feel included in their own treatment plans. That’s really important for overall success.”
Dick Gallup serves as the vice president of the governing board for Redfield Community Memorial Hospital Avera; he said he’s been impressed with Howard’s contributions.
“Doctors and advanced practice providers are busy, and as a member of the team, she can see quite a few patients and that gives our doctors time to see others,” Dick Gallup said. “Doc Owens has been instrumental in getting this program working, and Aly’s started things mostly from scratch, so there’s been a little shaking up – for the good. We’re excited to see how things will unfold in Britton.”
Expansion to Britton
Howard will continue to expand her innovative approach to rural clinical pharmaceutical care, as she’ll work with providers and patients to implement anticoagulation clinical services as well as other consultation in Britton at Marshall County Healthcare Center Avera.
“Sharing resources between two locations allows us to apply the lessons we’ve learned in both locations, which provides more effective, collaborative care” said Howard. “In facilities without clinical pharmacists, much of the research and medication management falls to the physicians and advanced practice professionals. We have great resources in the Avera eCARE® Pharmacy service, but having a person who is on the ground, talking to nurses and medical staff, meeting with patients – that eyes-on paradigm becomes a critical part to seeing more success and continuing to improve outcomes.”
For patients like Marge, there’s more to it than just outcomes.
“Aly is great about making you feel like she understands what you’re facing and she’s never afraid to talk to the doctor about approaches or considerations,” she said. “I know Dr. Owens feels she’s a great addition, and I think the other physicians appreciate having her on the team. I sure know she helps both of us with our care.”